BCMA loss in the epoch of novel immunotherapy for multiple myeloma: from biology to clinical practice

Haematologica. 2023 Apr 1;108(4):958-968. doi: 10.3324/haematol.2020.266841.

Abstract

The treatment of multiple myeloma (MM) is evolving rapidly. In the past few years, chimeric antigen receptor modified T cells and bispecific antibodies are bringing new treatment options to patients with relapsed/refractory MM. Currently, B-cell maturation antigen (BCMA) has emerged as the most commonly used target of T-cell-based immunotherapies for relapsed/refractory MM. Clinical data have demonstrated promising efficacy and manageable safety profiles of both chimeric antigen receptor T-cell and bispecific antibody therapies in heavily pretreated relapsed/refractory MM. However, most patients suffer from relapses at later time points, and the mechanism of resistance remains largely unknown. Theoretically, loss of antigen is a potential tumor-intrinsic resistance mechanism against BCMA-targeted immunotherapies. Strategies to overcome this kind of drug resistance are, therefore, needed. In this review, we discuss the loss of BCMA in the new epoch of immunotherapy for MM.

Publication types

  • Review

MeSH terms

  • Antibodies, Bispecific* / therapeutic use
  • B-Cell Maturation Antigen
  • Biology
  • Humans
  • Immunotherapy
  • Immunotherapy, Adoptive / adverse effects
  • Multiple Myeloma* / drug therapy
  • Neoplasm Recurrence, Local / drug therapy
  • Receptors, Chimeric Antigen*

Substances

  • Receptors, Chimeric Antigen
  • B-Cell Maturation Antigen
  • Antibodies, Bispecific