CAR T Therapy Demonstrates Improved Efficacy but Increased Toxicity in Patients With Relapsed or Refractory MM

Key Takeaways:

• Across a 2-year treatment period, chimeric antigen receptor (CAR) T-cell therapy was associated with a higher overall survival (OS) than teclistamab for patients with relapsed or refractory multiple myeloma.
• Although CAR T therapy had better efficacy, it was also associated with an increased risk of adverse events (AEs), specifically cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS).
• Physicians should break down the various benefits and risks of each treatment option and guide patients toward choosing the therapy best suited to their individual treatment plan and goals.

An abstract presented at the 2026 American Society of Clinical Oncology (ASCO) meeting compared the OS and safety profile of CAR T-cell therapy against teclistamab. The study observed outcomes after 2 years of treatment to evaluate the long-term effects of both regimens on relapsed or refractory MM.

Researchers collected data from TriNetX US Collaborative Network to identify patients with MM who were treated with either CAR T therapy or teclistamab between 2021 and 2023. Propensity score matching was performed to narrow the population size and balance baseline demographics, comorbidities, and prior treatments.

CAR T vs Teclistamab

The initial study size included 858 patients with relapsed or refractory MM. Out of this group, 351 were treated with CAR T therapy, and 507 were treated with teclistamab. After propensity score matching, each cohort contained 227 patients.

Patients who received CAR T therapy had higher rates of OS than those who received teclistamab, indicating CAR T therapy has a higher efficacy.

On the other hand, patients with CAR T therapy also had higher rates of AEs such as CRS and ICANS than patients who received teclistamab.

Implications for Oncology Care

While CAR T-cell therapy demonstrated improved efficacy and better OS than teclistamab, it also resulted in increased toxicity that may impede quality of life for patients. Physicians should discuss the benefits and risks of both treatments and help patients determine which option best aligns with their own care goals.

The study’s authors note, “These findings build upon prior short-term data and underscore the need for prospective studies directly comparing BCMA-targeted treatment strategies across longer follow-up intervals.”

Reference

Song J, Fai Li W, Li Y, et al. Updated two-year overall survival and toxicity outcomes of BCMA CAR-T therapy compared with teclistamab in multiple myeloma. J Clin Oncol. 2026;44(16):7527. doi:10.1200/JCO.2026.44.16_suppl.7527