Efficacy and Safety Comparisons of Four Approved Chimeric Antigen Receptor T-Cell Therapies in Multiple Myeloma

Despite significant advances in novel therapies, multiple myeloma (MM) remains incurable due to inevitable relapse. Chimeric antigen receptor (CAR) T-cell therapy is an innovative immunotherapy that has demonstrated remarkable efficacy in patients with relapsed/refractory (R/R) MM. To date, four B-cell maturation antigen (BCMA)-targeting CAR T-cell therapies have been approved in the United States and China for the treatment of R/R MM: idecabtagene vicleucel, ciltacabtagene autoleucel, equecabtagene autoleucel, and zevorcabtagene autoleucel. Although these four CAR T-cell therapies have achieved encouraging response rates in R/R MM, a comprehensive comparative analysis of their efficacy and toxicity profiles is still lacking. In this review, we compare the efficacy and safety of these four approved BCMA-directed CAR T-cell therapies. We also discuss potential factors underlying the observed differences and highlight strategies that may further improve the clinical outcomes of this revolutionary therapy.