PhD Scientific Days 2025

Poster Session II. - E: Pathological and Oncological Sciences

Efficacy and Safety Comparison of CAR T-cell Therapy versus Standard of Care in Multiple Myeloma Patients - a Systematic Review and Meta-Analysis

Name of the presenter

Szilágyi Ádám

Institute/workplace of the presenter

Centre for Translational Medicine, Semmelweis University, Budapest, Hungary

Authors

Ádám Szilágyi¹, Petra Varga^1,2, Gergely Agócs^1,3, Tamás Kói^1,4, Márk Hernádfői^1,5, Ximeng Li¹, Attila Kovács⁶, Szilárd Váncsa^1,7, Klementina Ocskay^1,2, Péter Hegyi^1,7,8, Miklós Garami^1,9

1: Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
2: Heim Pál National Pediatric Institute, Budapest, Hungary
3: Department of Biophysics and Radiation Biology, Semmelweis University, Budapest, Hungary
4: Department of Stochastics, Institute of Mathematics, Budapest University of Technology and Economics, Budapest, Hungary
5: Bethesda Children’s Hospital, Budapest, Hungary
6: University of Debrecen, Debrecen, Hungary
7: Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
8: Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
9: Pediatric Center, Semmelweis University, Budapest, Hungary

Text of the abstract

Relapse/Refractory Multiple Myeloma (MM) patients, who could not respond after several treatment lines with current Standard of Care, rely on novel therapeutic interventions. Chimeric antigen receptor (CAR) T-cell therapies have already shown clinical success in hematological cancers regarding response or survival outcomes, but several treatment-specific adverse events (AE), such as cytokine release syndrome (CRS) could increase the risk of unsuccessful recovery. We aimed to analyze the available literature comparing CAR T-cell therapy with SoC efficacy and safety within patients with MM.
The literature search was conducted in three databases (Embase, Medline, and Central) on 02nd February 2024. Articles reporting data with compared cohorts of CAR T-cell versus control treatments were included after selection process, then we extracted odds ratios (ORs) and hazard ratios (HRs) of response and survival data with a 95% confidence interval (CI). We distributed efficacy results according to follow-up (ITT/mITT) and statistical approaches. OR of treatment related AE was calculated from the number of patients with events. Digitalized Kaplan-Meyer (KM) curves were created to analyze pooled survival curves.
Of 29915 hits, 11 MM studies were included. The complete response was OR=11.04 (95% CI=7.50-16.25) and overall response rate was OR=5.34 (95% CI=1.07-27.14). Overall survival was HR=0.47 (95% CI= 0.14-1.59), progression-free survival was HR=0.30 (95% CI=0.11-0.77) and pooled KM curves of 24 months supported this result. In the safety analysis, patients with any serious AEs were not significantly different in the cohorts: OR=5.10 (95% CI=0.35-74.19). Only nausea increased significantly during CAR T-cell treatment compared to SoC: OR=3.24 (95% CI=1.32-7.93).
Despite the risk of CRS, CAR T-cell therapy in MM is a beneficial, similarly safe therapy compared to SoC, with decreased risk of progression.
This study was conducted as part of the Centre for Translational Medicine PhD program.