CAR T-cell therapy is one of the most promising advances for patients with relapsed or refractory multiple myeloma, offering high response rates even after other treatments stop working. Evidence available up to 2025 shows that around 80–90% of appropriately selected patients respond, and about half or more achieve very deep remissions, although the myeloma can still return over time.
CAR T success rates for myeloma in 2025
Evidence from pivotal trials of BCMA-directed CAR T products (such as idecabtagene vicleucel and ciltacabtagene autoleucel) and real-world analyses up to 2024–2025 shows consistently high response rates in late-line multiple myeloma. While exact figures differ by product, dose, and patient population, the following ranges capture the 2025 landscape:
- Overall response rate (ORR): In many major studies, about 80–90% of treated patients have a measurable response.
- Deep responses: Roughly 40–70% achieve complete or near-complete remission (for example, complete/stringent complete response or at least very good partial response), often with minimal residual disease (MRD) negativity on sensitive tests.
- Duration of response / PFS: Median progression-free survival frequently falls between about 8 and 20+ months, with longer benefit in patients who achieve the deepest remissions and in some newer constructs or earlier lines of use.
Why success rates vary between patients
Even within the same study, not every patient experiences the same level or duration of benefit. Several factors influence individual outcomes with CAR T-cell therapy for myeloma:
- Disease stage and prior therapy
Patients who receive CAR T after many prior lines of treatment often have more resistant disease, which can shorten the duration of response compared with those treated slightly earlier in their disease course. As trials move CAR T into earlier lines, emerging data suggest that durability of remission may improve for some patients. - Tumor burden and risk features
High tumor burden, aggressive relapse, and high-risk cytogenetic features (for example certain chromosomal abnormalities) can make myeloma harder to control, even when the initial CAR T response is good. Conversely, lower disease burden and standard-risk biology are often associated with longer-lasting remissions. - Type of CAR T product and protocol
Different CAR constructs (single vs dual antigen targeting, co-stimulatory domains, dose levels) have distinct efficacy and toxicity profiles, leading to some variation in ORR, depth of response, and PFS across products. Clinical trials and real-world registries continue to refine dose, schedule, and patient selection to optimize results. - Center experience and supportive care
High-volume CAR T centers typically have streamlined logistics, experienced multidisciplinary teams, and established protocols for early recognition and management of side effects. This helps reduce complications and ensures appropriate follow-up, which indirectly contributes to overall treatment success.
Publication date: December 2025
Sources
Updates on CAR T cell therapy in multiple myeloma
CAR T-Cell therapy for Myeloma: Where are we now and what is needed to move CAR T-cells forward to earlier lines of therapy?
New Frontiers: The Role of CAR T-Cell Therapy in Multiple Myeloma
CAR-T cell therapy in Multiple Myeloma: current status and future challenges
CAR T therapies in multiple myeloma: unleashing the future
CAR T cell therapy in multiple myeloma, where are we now and where are we heading for?
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