Introduction

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As CAR-T therapy continues to develop as an advanced treatment for multiple myeloma, many patients and caregivers are interested in understanding how different CAR-T therapies compare. This post presents a neutral, fact-based comparison of two FDA-approved CAR-T therapies—Abecma and Carvykti—and highlights an emerging third therapy currently under clinical investigation. This information is intended to help readers make informed, research-based observations—not as medical advice.

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​​​​​​​What is CAR-T Therapy?

 

To understand what CAR-T therapy is, first we have to be familiar with T cells. T cells are a type of immune cell naturally present in the body to find and kill invaders. However, cancer cells often evade detection by the T cells. 

So, CAR-T cell therapy involves taking the patient’s T cells and reprogramming them in the lab to have a CAR, or chimeric antigen receptor, attached. The CAR protein helps the T cells to recognize the cancer cells more effectively. It’s like giving your T cells a police sketch of the cancer cells so the T cells can find and destroy the cancer cells.

 

 

How the CAR-T Process Works

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1. T cell Collection: Patient's blood is drawn to collect T cells from their blood; this process is called apheresis

2. Engineering: In a lab, the CAR protein is attached to the T cells

3. Multiplication: The CAR-T cells are multiplied to a larger number

4. Infusion: Patient receive a single infusion of the CAR-T cells

5. Attack: These CAR-T cells now find and kill cancer cells

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Science Corner

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CAR-T cells work by using an antibody, a receptor which recognizes a specific protein on the surface of the cancer cell. 

When this receptor binds to the cancer cell, it triggers a chain reaction inside the T cell that causes the T cell to release toxins, like cytokines, to destroy the cancer cell. 

This is why its important that the CAR-T cell antibody targets a protein that is only on the cancer cell, or else it could mistakenly attack healthy cells.

Both of the approved CAR-T therapies for Multiple Myeloma, listed below, use an antibody targeting the protein BCMA, which is found exclusively on the multiple myeloma cells. 

 

 

Approved CAR-T Therapies for Multiple Myeloma

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As of July 2025, there are two FDA-approved CAR-T therapies for Multiple Myeloma:

• Abecma (idecabtagene vicleucel)

• Carvykti (ciltacabtagene autoleucel)

These CAR-T therapies are used after four or more lines, or different types, of treatments have been used, including:

• an immunomodulating agent

• a proteasome inhibitor

• an anti-CD38 monoclonal antibody

 

How Does CAR-T Compare to Standard Therapies?

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Benefits:

• Largely successful results: in an FDA clinical trial for Carvykti 98% of patients saw reduced cancer, and 76% saw complete removal of cancer for an average of 22 months 

• Once time infusion: Unlike rounds of chemotherapy and blood transplants, CAR-T therapy only requires a single transfusion

Challenges:

• Side effects

  • Cytokine Release Syndrome (CRS): a common side effect where the CAR-T cells release an excess of the cancer-killing toxins, called cytokines, into the bloodstream. This can cause issues such as high fever, nausea, increased heartbeat, and muscle pain. 

  • Neurological issues: also known as immune effector cell-associated neurotoxicity syndrome (ICANS); side effects range from headaches and mild confusion to seizures and difficulty speaking (aphasia)  

• Very high cost: the treatment can cost around $465K+

 

Patient Resources

Find a CAR-T Center

• Abecma Center Finder

• Carvykti Treatment Locator​

Explore Clinical Trials

• CAR-T Trials for MM on ClinicalTrials.gov