Assessment of the effectiveness and safety of CAR-T Cell therapy in multiple myeloma patients with relapsed or refractory disease: a systematic review and meta-analysis

Abstract

Multiple myeloma (MM), the second most common hematologic malignance, remains incurable, and its incidence is rising. Chimeric Antigen Receptor T-cell (CAR-T cell) therapy emerges as a novel treatment with the potential to improve the survival and quality of life of patients with relapse/refractory multiple myeloma (rrMM). In this systematic review and meta-analysis, we aim to provide a concise overview of the latest developments in CAR-T therapy, assess their potential implications for clinical practice, and evaluate their efficacy and safety outcomes based on the most up-to-date evidence. A literature search conducted from 01/01/2019 to 12/07/2023 on Medline/PubMed, Scopus, and Web of Science identified 2273 articles, of which 29 fulfilled the specified criteria for inclusion in the meta-analysis. The Methodological Items for Non-Randomized Studies (MINORS) were used for evaluating the methodological quality. This comprehensive review and meta-analysis followed PRISMA guidelines, with all components evaluated by two independent reviewers. The results of this meta-analysis offer robust evidence supporting the efficacy of CAR-T cell therapy in the treatment of rrMM patients with a generally safe profile and manageable side effects. Our subgroup analysis underscored the influence of prior treatment history and the patient's myeloma profile on both effectiveness and safety outcomes.