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.