在多发性骨髓瘤中,T细胞重定向双特异性和三特异性抗体,超出BCMA
Niels W C J van de Donk1,2, Chloe O'Neill1,2, Maaike E M de Ruijter1,2
1Department of Hematology, Amsterdam UMC, location Vrije Universiteit Amsterdam.
Current opinion in oncology
|July 28, 2023
概括
新的T细胞疗法,包括针对新型抗原的双特异性抗体,如GPRC5D和FcRH5,对在BCMA导向治疗中进展的多发性骨髓瘤患者有希望. 进一步的研究正在探索组合策略和三种特异性抗体以改善结果.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 血液学 血液学 血液学
背景情况:
- 针对B细胞成熟抗原 (BCMA) 的免疫疗法,如CAR T细胞和双特异性抗体 (BsAbs),改善了三级耐火性多发性髓瘤 (MM) 的存活率.
- 尽管取得了进展,但疾病的进展仍然是一个挑战,需要针对耐火性MM患者提供新的治疗药物.
研究的目的:
- 审查新的T细胞重定向BsAbs针对多发性骨髓瘤中的替代抗原.
- 讨论这些新兴疗法的疗效和毒性概况.
- 突出三种特异性抗体 (TsAbs) 在克服治疗耐药性的潜力.
主要方法:
- 审查最近的临床试验数据和关于T细胞重定向治疗多发性骨髓瘤的科学文献.
- 对针对G蛋白结合受体类5成员D (GPRC5D) 和Fc受体同类5 (FcRH5) 的新型BsAbs的分析.
- 评估新兴的三特异性抗体 (TsAb) 策略.
主要成果:
- 针对GPRC5D (talquetamab,forimtamig) 和FcRH5 (cevostamab) 的新型BsAbs在重度预治疗的MM中显示出前景,包括之前使用BCMA导向疗法治疗的患者.
- 常见的毒性包括细胞因子释放综合征,细胞衰竭和感染. 针对GPRC5D的BsAbs具有独特的"在瘤上/离瘤"的毒性,如皮疹和.
- 针对多个抗原或提供T细胞共同刺激的三特异性抗体处于早期发展阶段.
结论:
- 转向T细胞的BsAbs在晚期多发性髓瘤中显示出有前途的活性和可控的毒性.
- 目前正在进行的研究重点是组合疗法,固定的治疗时间,以及早期使用BsAbs.
- 三特异性抗体代表了多发性骨髓瘤治疗的有希望的未来方向.
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