{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T18:28:40Z","timestamp":1793644120276,"version":"4.5.1"},"reference-count":42,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Leipzig","id":[{"id":"https:\/\/ror.org\/028hv5492","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Hematol Oncol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chimeric antigen receptor T cells and bispecific antibodies, are moving from late-line salvage into early relapsed multiple myeloma. Indirect comparisons in heavily pretreated patients have favored cell therapy, but whether that hierarchy holds in early relapse is unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed randomized phase 3 trials comparing a T-cell-redirecting therapy against a daratumumab-pomalidomide-dexamethasone-type control after at least one prior line. Pseudo-individual patient time-to-event data were reconstructed from published survival curves. Regimens were compared indirectly in Bayesian network meta-analyses reported under fixed-effect and random-effects assumptions, re-estimated in a frequentist graph-theoretical model. Control-arm dispersion was quantified by random-effects synthesis of median progression-free survival. Overall survival was additionally analyzed as restricted mean survival differences at 24 and 36 months. Safety and a cost-consequence analysis were assessed descriptively (PROSPERO: CRD420261431847).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Four trials (2,174 patients) investigating ciltacabtagene autoleucel, teclistamab-daratumumab, and talquetamab-daratumumab with or without pomalidomide were included. Control-arm median progression-free survival spanned 9.9 to 24.4 months (I-squared 91%). Under fixed effects, teclistamab-daratumumab ranked first for progression-free survival (P-score 98%, the mean probability of outranking a competing treatment rather than the probability of being best) and separated from talquetamab-daratumumab (hazard ratio 0.55, 95% credible interval 0.34 to 0.88). Once between-trial heterogeneity was admitted, every contrast crossed unity (versus ciltacabtagene autoleucel 0.62, 0.21 to 1.81). Overall survival was concordant under both models (teclistamab-daratumumab versus ciltacabtagene autoleucel 0.94, 0.55 to 1.62), with restricted mean survival gains over control of 0.7 to 1.6 months at 24 months and rankings between 56% and 70%. Toxicity profiles differed across modalities, although their overall burden cannot be reliably compared across trials. Cost per progression-free month, computed against a population-standardized denominator, was lowest for cilta-cel and converged with the bispecific regimens only under short, fixed treatment durations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Randomized evidence in early relapse does not establish an efficacy hierarchy among these regimens. Progression-free survival estimates favored teclistamab-daratumumab, but no contrast was robust to plausible between-trial heterogeneity, and equivalence could not be demonstrated. Until comparative data exist, treatment selection cannot rest on efficacy data alone and will be informed by patient- and disease-related factors, toxicity, sequencing, access, and cost.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13045-026-01850-2","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T09:04:27Z","timestamp":1791363867000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["T-cell-redirecting therapies in early relapsed multiple myeloma: a systematic review and network meta-analysis"],"prefix":"10.1186","volume":"19","author":[{"given":"Maximilian","family":"Merz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joao Tadeu","family":"Souto Filho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter M.","family":"Voorhees","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hermann","family":"Einsele","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fredrik","family":"Schjesvold","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward R. Scheffer","family":"Cliff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria-Victoria","family":"Mateos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vania","family":"Hungria","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yael C.","family":"Cohen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos Fern\u00e1ndez","family":"de Larrea","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meral","family":"Beksac","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ola","family":"Landgren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saad Z.","family":"Usmani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luciano J.","family":"Costa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nico","family":"Gagelmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"issue":"10297","key":"1850_CR1","doi-asserted-by":"publisher","first-page":"314","DOI":"10.1016\/S0140-6736(21)00933-8","volume":"398","author":"JG Berdeja","year":"2021","unstructured":"Berdeja JG, Madduri D, Usmani SZ, et al. 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N Engl J Med. 2026. https:\/\/doi.org\/10.1056\/NEJMoa2603870.","journal-title":"N Engl J Med"}],"container-title":["Journal of Hematology &amp; Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13045-026-01850-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13045-026-01850-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13045-026-01850-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T17:40:23Z","timestamp":1793641223000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13045-026-01850-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,7]]},"references-count":42,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["1850"],"URL":"https:\/\/doi.org\/10.1186\/s13045-026-01850-2","relation":{},"ISSN":["1756-8722"],"issn-type":[{"value":"1756-8722","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,7]]},"assertion":[{"value":"31 July 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 September 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 October 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Not applicable.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"M.M. has received honoraria from Janssen, Bristol Myers Squibb (BMS), Amgen, AbbVie, Stemline Therapeutics, Takeda, Sanofi and Pfizer; has held consulting or advisory roles for Janssen, BMS, Pfizer and Sanofi; has received research funding from Janssen, SpringWorks Therapeutics and Roche\/Genentech; and has received travel support from Janssen, Stemline Therapeutics and Pfizer. P.M.V. has acted as a consultant for AbbVie, BMS, GSK, Janssen, Karyopharm Therapeutics and Regeneron; has served on advisory boards for AbbVie, BMS and Sanofi; and has received research funding from AbbVie, GSK, Janssen and Nerviano Medical Sciences. H.E. has held consulting or advisory roles for Amgen, BMS, Celgene, GSK, Johnson & Johnson, Novartis, Sanofi and Takeda; has received honoraria from Amgen, BMS, Celgene, GSK, Johnson & Johnson, Novartis, Sanofi and Takeda; has received research funding from Amgen, Celgene\/BMS, Janssen, GSK, Sanofi and Novartis; and has received travel support from Amgen, BMS, Celgene, Novartis, Sanofi and Takeda. F.S. has received research grants from Celgene, GSK, Janssen, Oncopeptides, Targovax and Sanofi; has received honoraria or speakers\u2019 bureau fees from AbbVie, Amgen, BMS, Daiichi Sankyo, GSK, Janssen, Novartis, Oncopeptides, Pfizer, Sanofi, SkylineDx and Takeda; and has served on advisory boards or data safety monitoring boards for AbbVie, Celgene, GSK, Janssen, Oncopeptides, Sanofi and Takeda. M.-V.M. has received honoraria from AbbVie, Amgen, BMS, GSK, Johnson & Johnson, Pfizer, Regeneron, Sanofi and Stemline Therapeutics; has held advisory roles for AbbVie, Amgen, BMS, GSK, Johnson & Johnson, Kite, Oncopeptides, Pfizer, Regeneron, Roche, Sanofi, Stemline Therapeutics and Takeda; and is a speakers\u2019 bureau member for Janssen Cilag. V.H. has received honoraria from and served on advisory boards for BMS, Pfizer, Takeda, AbbVie, GSK, Sanofi, Amgen and Johnson & Johnson; and has participated in speakers\u2019 bureaus for Pfizer and Regeneron. Y.C.C. has held consulting or advisory roles for Amgen, BMS, GSK, Johnson & Johnson, Medison, Pfizer, Roche, Sanofi and Takeda; has received honoraria from Amgen, GSK, Janssen, Medison, NeoPharm and Takeda; has received institutional research funding from Amgen, Karyopharm Therapeutics, Johnson & Johnson and Takeda; and has participated in speakers\u2019 bureaus for GSK and Johnson & Johnson. C.F.d.L. has received honoraria from Janssen, BeiGene, BMS, Pfizer, Amgen, GSK, Takeda and Sanofi; has held consulting or advisory roles for Janssen, BMS, GSK, Sanofi, BeiGene and Amgen; has received research funding from Janssen, BMS, Takeda, Amgen and Cellectar Biosciences; and has received travel support from BeiGene and Janssen. M.B. has received research funding from Janssen and GSK; has participated in speakers\u2019 bureaus for Janssen, Sanofi, BMS and Amgen; and has served in consulting or advisory roles for Takeda and Menarini. O.L. has held consulting or advisory roles and received honoraria from Amgen, Celgene\/BMS, Janssen, Takeda, Adaptive Biotechnologies, Merck, Theradex and AstraZeneca; and has served on independent data-monitoring committees for several of these companies. S.Z.U. has held consulting or advisory roles for AbbVie, Amgen, BMS, Celgene, Genentech, Gilead Sciences, GSK, Janssen, Karyopharm Therapeutics, Merck and Takeda; and has received research funding from Amgen, Array BioPharma, BMS, Celgene, GSK, Janssen, Merck, Pharmacyclics, Sanofi, Seattle Genetics and Skyline Diagnostics. L.J.C. has received consulting fees, honoraria and research funding from Genentech\/Roche, BMS, Johnson & Johnson, AbbVie, Caribou Biosciences, AstraZeneca and Amgen; consulting fees and honoraria from Sanofi and Pfizer; and honoraria from Adaptive Biotechnologies. N.G. has held consulting or advisory roles for Stemline Therapeutics and MorphoSys; and has received travel support from BMS\/Celgene and Janssen.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"83"}}