An analysis of multiple myeloma clinical trials from 2014–2024 finds CAR-T therapies now represent nearly half of studies, highlighting a pipeline realignment toward cell-based immunotherapies. The review, using ClinicalTrials.gov and Cortellis Drug Discovery Intelligence, reports cell therapies accounted for 46.8% of trials, with small molecules at 31% and T-cell-engaging antibodies at 16%. It also points to regulatory pathways—such as FDA accelerated approval—as a driver of increased clinical entry. For developers, the findings frame competitive pressure around CAR-T targets, study design innovation in early-phase settings, and trial throughput strategies in a crowded myeloma landscape.