SynthesisFrontiers in oncology2026
Efficacy and safety of CD38-directed CAR-T cell therapy for multiple myeloma: a systematic review and meta-analysis.
Synthesis in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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8 authors.
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Abstract
Background: Relapsed/refractory multiple myeloma (RRMM) remains a clinical challenge despite therapeutic advances. CD38-directed chimeric antigen receptor T-cell (CAR-T) therapy, especially dual-target CD38/BCMA constructs, represents an emerging immunotherapeutic strategy. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of CD38-directed CAR-T in RRMM. Methods: We systematically searched Medline, Embase, and Cochrane Library up to October 1, 2025. Eligible clinical trials investigating CD38-directed CAR-T (single-target or dual-target CD38/BCMA) for RRMM were included. Random-effects model was used to pool efficacy and safety outcomes of dual-target studies, while single-target CD38 data were summarized descriptively. Results: A total of 4 studies involving 70 patients were included (3 dual-target CD38/BCMA studies, n=61; 1 single-target CD38 study, n=9). For dual-target CD38/BCMA CAR-T, the pooled overall response rate (ORR) was 89% (95% CI: 81%-97%), complete response/stringent complete response (CR/sCR) rate was 63% (95% CI: 44%-82%), and minimal residual disease (MRD)-negative rate was 67%. Mortality was 11%. The single-target CD38 CAR-T showed lower efficacy (ORR = 33%) and higher mortality (44%). Any-grade cytokine release syndrome (CRS) occurred in 83% of patients, with grade ≥3 CRS in 26%. Other adverse events included infections (23%), immune effector cell-associated neurotoxicity syndrome (ICANS, 13%), and kidney injury (13%). Conclusion: Dual-target CD38/BCMA CAR-T demonstrates promising efficacy and manageable safety in RRMM. Evidence for single-target CD38 CAR-T remains limited and requires cautious interpretation. Further large-scale comparative studies are warranted to determine the optimal role of CD38-directed CAR-T in RRMM treatment sequencing.
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