Efficacy and safety of chimeric antigen receptor T-cell therapy versus standard treatment in hemato-oncology: A systematic review and meta-analysis
In brief
CAR T therapy cuts progression or death by 70% in myeloma
Across 71 comparative studies, CAR T-cell therapy was linked to a 70% lower risk of progression or death than standard or targeted treatment in multiple myeloma. It also improved some outcomes in lymphoma and leukemia, but advantages depended on the disease and comparator; overall toxicity was not higher, and more comparator-specific evidence is needed in leukemia.
- Journal
- European journal of cancer (Oxford, England : 1990) (Q1)
- Published
- 3 November 2026
- Study design
- Systematic review of cohort studies
- Evidence level
- Level 2, Moderate (CEBM 2a)
- Authors
- Ádám Szilágyi, Petra Varga, Gergely Agócs, Tamás Kói, Márk Hernádfői, Ximeng Li, et al.
- PMID
- 42987486
- DOI
- 10.1016/j.ejca.2026.117820
Why clinicians should know about it
- Picked for Oncology and Radiation Oncology (paper of the day, 8 November 2026): Compares CAR-T efficacy with standard therapy across blood cancers
- Picked for Hematology (paper of the day, 8 November 2026): Comparative CAR-T efficacy across lymphoma, ALL, and myeloma
Abstract
BACKGROUND: Chimeric antigen receptor (CAR) T-cell therapy has been compared with established non-CAR T treatments in several hematological malignancies, but the magnitude and consistency of benefit across diseases and comparators remain unclear. We conducted a systematic review and meta-analysis of comparative studies in non-Hodgkin lymphoma (NHL), acute lymphoblastic leukemia (ALL), and multiple myeloma (MM). METHODS: 71 comparative studies evaluating CAR T-cell therapy versus standard chemoimmunotherapy (SOC), targeted therapy (TAT), transplantation, chemotherapy or donor lymphocyte infusion (DLI) comparators were included. Outcomes were analyzed separately by disease entity. Treatment effects were summarized using odds ratios (ORs) for response and hazard ratios (HRs) for survival with random-effects models. RESULTS: In NHL, largely driven by large B-cell lymphoma (LBCL), CAR T-cell therapy increased response compared with SOC (OR=2.48, 95% CI=1.35-4.57) and improved overall survival (OS) (HR=0.61, 95% CI=0.48-0.78). Progression-free survival (PFS) was longer with CAR T-cells therapy than SOC in second-line LBCL, whereas no clinical advantage was observed over TAT or transplantation. In follicular lymphoma, CAR T-cells prolonged PFS versus SOC, while OS differences varied across comparators. In MM, CAR T-cells increased PFS compared with SOC or TAT (HR=0.30, 95% CI=0.11-0.77) and OS favored CAR T-cell infused patients. In ALL, OS favored CAR T-cell versus chemotherapy or DLI (HR 0.30, 95% CI=0.25-0.36) and was associated with fewer graft-versus-host disease events after transplantation. CONCLUSIONS: CAR T-cell therapy provides disease- and comparator-specific efficacy advantages without increased overall toxicity. Benefits are most consistent for PFS in LBCL and MM, however, in ALL, further comparator-specific evidence is needed.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.