Safety and clinical efficacy of BCMA CAR-T-cell therapy in multiple myeloma

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RESEARCH

Safety and clinical efficacy of BCMA CAR‑T‑cell therapy in multiple myeloma Gils Roex1†, Marijke Timmers2†, Kristien Wouters3, Diana Campillo‑Davo1, Donovan Flumens1, Wilfried Schroyens2, Yiwei Chu4, Zwi N. Berneman2, Eva Lion1, Feifei Luo4,5 and Sébastien Anguille1,2* 

Abstract  Background:  B-cell maturation antigen (BCMA)-targeted chimeric antigen receptor (CAR)-T-cell therapy is an emerg‑ ing treatment option for multiple myeloma. The aim of this systematic review and meta-analysis was to determine its safety and clinical activity and to identify factors influencing these outcomes. Methods:  We performed a database search using the terms “BCMA,” “CAR,” and “multiple myeloma” for clini‑ cal studies published between 01/01/2015 and 01/01/2020. The methodology is further detailed in PROSPERO (CRD42020125332). Results:  Twenty-three different CAR-T-cell products have been used so far in 640 patients. Cytokine release syndrome was observed in 80.3% (69.0–88.2); 10.5% (6.8–16.0) had neurotoxicity. A higher neurotoxicity rate was reported in studies that included more heavily pretreated patients: 19.1% (13.3–26.7; I2 = 45%) versus 2.8% (1.3–6.1; I2 = 0%) (p