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在多发性骨髓瘤中双特异性抗体的演变

Rebecca Ibrahim¹, Nadine Khalife², Ahmadreza Arbab³

¹International Department, Gustave Roussy Cancer Campus, Villejuif, France.

Chinese clinical oncology

|March 9, 2026

概括

针对BCMA和GPRC5D等抗原的双特异性抗体 (BsAbs) 已经彻底改变了多发性骨髓瘤 (MM) 治疗. 本综述探讨了它们的机制,临床活性,耐药性以及管理复发性/耐药性MM的未来策略.

科学领域:

血液学血液学血液学
免疫治疗是一种免疫疗法.
在瘤学瘤学.

背景情况:

多发性骨髓瘤 (MM) 治疗已通过向CD38单克隆抗体和向B细胞成熟抗原 (BCMA) 的疗法取得显著进展.
双特异性抗体 (BsAbs) 是一种新型的抗原向疗法,最初用于B细胞淋巴瘤,现在用于MM.
针对BCMA,GPRC5D或FcRH5的几个BsAbs已被批准用于复发性和/或耐火性 (R/R) MM.

研究的目的:

综述了用于多发性骨髓瘤 (MM) 治疗的最受研究的双特异性抗体 (BsAbs).
讨论与MM中BsAbs相关的作用机制,临床活性和抵抗机制.
探索BSAbs在MM治疗领域和新兴策略中的作用.

主要方法:

对多发性骨髓瘤 (MM) 中双特异性抗体 (BsAbs) 的临床数据和科学文献的审查.
对已批准的BsAbs进行分析,包括teclistamab,elranatamab,linvoseltamab和talquetamab.
讨论新的治疗策略,如结合BsAbs或使用三种特异性抗体.

主要成果:

四种BsAbs被FDA批准用于管理复发性和/或耐火性 (R/R) 多发性骨髓瘤 (MM).
通过吸引T细胞通过BCMA,GPRC5D和FcRH5.5等抗原来准MM细胞,BsAbs表现出显著的临床活性.
抗药性机制和克服它们的策略,包括组合疗法和三种特异性抗体,正在研究中.

结论:

双特异性抗体 (BsAbs) 已成为复发性和/或耐火性多发性髓瘤 (MM) 治疗的关键组成部分.
了解BsAbs的作用和抵抗机制是优化其使用的关键.
未来的方向包括结合BsAbs和探索新型药物,如三种特异性抗体,以提高有效性和克服MM的耐药性.

关键词:

B细胞成熟抗原 (BCMA) 是一种在Fc受体同类5 (FcRH5) 中.G蛋白结合受体家族C组5成员D (GPRC5D)多发性骨髓瘤 (MM) 是一种多发性骨髓瘤.双特异抗体 (BiAb) 是指两种特定的抗体.

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