B cell maturation antigen (BCMA)-based immunotherapy for multiple myeloma. (2nd November 2019)

• Record Type: Journal Article
• Authors: Tai, Yu-Tzu; Anderson, Kenneth C
• Is Part Of: Expert opinion on biological therapy. Volume 19:Number 11(2019)
• Page Start: 1143
• Page End: 1156
• Publication Date: 2019-11-02
• Subjects: Multiple myeloma (MM) -- B cell maturation antigen (BCMA) -- targeted immunotherapy -- monoclonal antibody (mAb) -- chimeric antigen receptor T cell (CAR T) -- antibody-drug conjugate (ADC) -- bi-specific T cell engager (BiTE) -- adoptive T cell therapy -- cancer vaccine -- bone marrow (BM) microenvironment -- minimal residual disease (MRD); Gene therapy -- Periodicals; Protein drugs -- Periodicals; Peptide drugs -- Periodicals; Immunotherapy -- Periodicals; Drug delivery systems -- Periodicals; 615.5
• DOI: 10.1080/14712598.2019.1641196
• Languages: English
• ISSNs: 1471-2598

Abstract

ABSTRACT: Introduction : B cell maturation antigen (BCMA) contributes to MM pathophysiology and is a target antigen for novel MM immunotherapy. Complete responses have been observed in heavily pretreated MM patients after treatment with BCMA antibody-drug conjugates (ADC), chimeric antigen receptor T, and bi-specific T cell engagers (BiTE®). These and other innovative BCMA-targeted therapies transform the treatment landscape and patient outcome in MM. Areas covered : The immunobiological rationale for targeting BCMA in MM is followed by key preclinical studies and available clinical data on efficacy and safety of therapies targeting BCMA from recent phase I/II studies. Expert opinion : BCMA is the most selective MM target antigen, and BCMA-targeted approaches have achieved high responses even in relapse and refractory MM as a monotherapy. Long-term follow-up and correlative studies using immuno-phenotyping and -sequencing will delineate mechanisms of overcoming the immunosuppressive MM bone marrow microenvironment to mediate additive or synergistic anti-MM cytotoxicity. Moreover, they will delineate cellular and molecular events underlying the development of resistance underlying relapse of disease. Most importantly, targeted BCMA-based immunotherapies used earlier in the disease course and in combination (adoptive T cell therapy, mAbs/ADCs, checkpoint and cytokine blockade, and vaccines) have great promise to achieve long-term disease control and potential cure.