Comparison of CAR T-cell and bispecific antibody as third-line or later-line treatments for multiple myeloma: a meta-analysis
Background CAR-T-cell therapy and bispecific antibody have revolutionized the treatment landscape for multiple myeloma. However, there is currently a lack of studies comparing the efficacy and safety of these two approaches. This meta-analysis assesses the efficacy and safety of B-cell maturation an...
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| Language: | English |
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BMJ Publishing Group
2024-11-01
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| Series: | Journal for ImmunoTherapy of Cancer |
| Online Access: | https://jitc.bmj.com/content/12/11/e010064.full |
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| author | Dan Liu Liang Wang Xiaojie Liang Yufan Wang Baiwei Luo Bingyu Lin WeiXiang Lu Shengyu Tian |
| author_facet | Dan Liu Liang Wang Xiaojie Liang Yufan Wang Baiwei Luo Bingyu Lin WeiXiang Lu Shengyu Tian |
| author_sort | Dan Liu |
| collection | DOAJ |
| description | Background CAR-T-cell therapy and bispecific antibody have revolutionized the treatment landscape for multiple myeloma. However, there is currently a lack of studies comparing the efficacy and safety of these two approaches. This meta-analysis assesses the efficacy and safety of B-cell maturation antigen (BCMA)-directed CAR-T-cell therapies and BCMA×CD3 bispecific antibodies as third-line or later interventions for relapsed/refractory multiple myeloma (RRMM).Methods We searched PubMed, Embase, Web of Science, and Cochrane databases up to May 31, 2024, identifying 11 eligible studies encompassing 1269 participants. Random-effects models evaluated the primary (complete response (CR) rate) and secondary (overall response rate (ORR)) outcomes, while meta-regression analyses adjusted for relevant covariates.Results CAR-T-cell therapy achieved significantly higher pooled CR rate (0.54 (95% CI 0.42–0.69) vs bispecific antibodies 0.35 (0.30–0.41), p<0.01) and pooled ORR (0.83 (0.76–0.90) vs 0.65 (0.59–0.71), p<0.01). However, CAR-T therapy had a higher incidence of adverse events, particularly cytokine release syndrome (CRS 0.83 (0.70–0.97) vs bispecific antibodies 0.59 (0.43–0.74), p<0.05). Severe CRS (grade ≥3) occurred at a rate of 0.07 (0.03–0.14) in the CAR-T cell group, contrasting with a negligible rate of 0.01 (0.00–0.02) in the bispecific antibody group (p<0.01). Hematologic adverse events, including neutropenia (grade ≥3; 0.88 (0.81–0.95) vs 0.48 (0.30–0.67), p<0.01) and anemia (grade≥3; 0.55 (0.47–0.62) vs 0.34 (0.28 to 0.40), p<0.01), were also more frequent in the CAR-T-cell group. Furthermore, differences in efficacy were observed among various CAR-T products, with ciltacabtagene autoleucel showing greater efficacy in CR rate (0.77 (0.71–0.84) vs 0.37 (0.32–0.41), p<0.01) and ORR (0.91 (0.83–0.99) vs 0.73 (0.68–0.77), p<0.01) compared with idecabtagene vicleucel.Conclusion CAR-T-cell therapy demonstrated superior CR rates compared with bispecific antibodies, although with an increase in severe adverse events. |
| format | Article |
| id | doaj-art-8da529ad02764449bb834280b7bd3154 |
| institution | Kabale University |
| issn | 2051-1426 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | BMJ Publishing Group |
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| series | Journal for ImmunoTherapy of Cancer |
| spelling | doaj-art-8da529ad02764449bb834280b7bd31542025-08-20T03:48:06ZengBMJ Publishing GroupJournal for ImmunoTherapy of Cancer2051-14262024-11-01121110.1136/jitc-2024-010064Comparison of CAR T-cell and bispecific antibody as third-line or later-line treatments for multiple myeloma: a meta-analysisDan Liu0Liang Wang1Xiaojie Liang2Yufan Wang3Baiwei Luo4Bingyu Lin5WeiXiang Lu6Shengyu Tian7Department of Radiology, Shunde Hospital of Southern Medical University, Foshan, Guangzhou, China1 Department of Hematology, Beijing Tongren Hospital, Capital Medical University, Beijing, China1 Department of Hematology, Beijing Tongren Hospital, Capital Medical University, Beijing, ChinaPeking University Sixth Hospital, Beijing, China2 Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China2 Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China1 Department of Hematology, Beijing Tongren Hospital, Capital Medical University, Beijing, China1 Department of Hematology, Beijing Tongren Hospital, Capital Medical University, Beijing, ChinaBackground CAR-T-cell therapy and bispecific antibody have revolutionized the treatment landscape for multiple myeloma. However, there is currently a lack of studies comparing the efficacy and safety of these two approaches. This meta-analysis assesses the efficacy and safety of B-cell maturation antigen (BCMA)-directed CAR-T-cell therapies and BCMA×CD3 bispecific antibodies as third-line or later interventions for relapsed/refractory multiple myeloma (RRMM).Methods We searched PubMed, Embase, Web of Science, and Cochrane databases up to May 31, 2024, identifying 11 eligible studies encompassing 1269 participants. Random-effects models evaluated the primary (complete response (CR) rate) and secondary (overall response rate (ORR)) outcomes, while meta-regression analyses adjusted for relevant covariates.Results CAR-T-cell therapy achieved significantly higher pooled CR rate (0.54 (95% CI 0.42–0.69) vs bispecific antibodies 0.35 (0.30–0.41), p<0.01) and pooled ORR (0.83 (0.76–0.90) vs 0.65 (0.59–0.71), p<0.01). However, CAR-T therapy had a higher incidence of adverse events, particularly cytokine release syndrome (CRS 0.83 (0.70–0.97) vs bispecific antibodies 0.59 (0.43–0.74), p<0.05). Severe CRS (grade ≥3) occurred at a rate of 0.07 (0.03–0.14) in the CAR-T cell group, contrasting with a negligible rate of 0.01 (0.00–0.02) in the bispecific antibody group (p<0.01). Hematologic adverse events, including neutropenia (grade ≥3; 0.88 (0.81–0.95) vs 0.48 (0.30–0.67), p<0.01) and anemia (grade≥3; 0.55 (0.47–0.62) vs 0.34 (0.28 to 0.40), p<0.01), were also more frequent in the CAR-T-cell group. Furthermore, differences in efficacy were observed among various CAR-T products, with ciltacabtagene autoleucel showing greater efficacy in CR rate (0.77 (0.71–0.84) vs 0.37 (0.32–0.41), p<0.01) and ORR (0.91 (0.83–0.99) vs 0.73 (0.68–0.77), p<0.01) compared with idecabtagene vicleucel.Conclusion CAR-T-cell therapy demonstrated superior CR rates compared with bispecific antibodies, although with an increase in severe adverse events.https://jitc.bmj.com/content/12/11/e010064.full |
| spellingShingle | Dan Liu Liang Wang Xiaojie Liang Yufan Wang Baiwei Luo Bingyu Lin WeiXiang Lu Shengyu Tian Comparison of CAR T-cell and bispecific antibody as third-line or later-line treatments for multiple myeloma: a meta-analysis Journal for ImmunoTherapy of Cancer |
| title | Comparison of CAR T-cell and bispecific antibody as third-line or later-line treatments for multiple myeloma: a meta-analysis |
| title_full | Comparison of CAR T-cell and bispecific antibody as third-line or later-line treatments for multiple myeloma: a meta-analysis |
| title_fullStr | Comparison of CAR T-cell and bispecific antibody as third-line or later-line treatments for multiple myeloma: a meta-analysis |
| title_full_unstemmed | Comparison of CAR T-cell and bispecific antibody as third-line or later-line treatments for multiple myeloma: a meta-analysis |
| title_short | Comparison of CAR T-cell and bispecific antibody as third-line or later-line treatments for multiple myeloma: a meta-analysis |
| title_sort | comparison of car t cell and bispecific antibody as third line or later line treatments for multiple myeloma a meta analysis |
| url | https://jitc.bmj.com/content/12/11/e010064.full |
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