Brief Insight About B-cell Maturation Antigen (BCMA) in Multiple Myeloma

Abstract

 Background:   There have been significant advancements in the treatment of multiple myeloma (MM) in the previous decade, yet a large percentage of patients still do not react or have a short duration of response to existing medications. In addition, not all patients will have the same level of tolerance for these treatments, and they might cause significant morbidity. Relapsed or refractory MM develops when individuals develop resistance to treatments for multiple myeloma, which is a condition for which there is now no cure. Consequently, there is a need for MM medicines that have not yet been developed, ideally ones that have new action mechanisms that can produce long-lasting effects, avoid drug resistance, and/or have better side effects. B-cell maturation antigen (BCMA) is an antigen that mature B cells preferentially express. It has been linked to multiple myeloma (MM) in both humans and preclinical animals, suggesting that it could be a useful treatment target for MM. Further evidence for BCMA's utility as an MM biomarker comes from its association with clinical state, its predictive significance, and its applicability to patient populations that have historically been challenging to monitor. Here, we take a look at three typical approaches to treating MM that target BCMA: chimeric antigen receptor (CAR)-modified T-cell therapy, antibody-drug conjugates, and bispecific antibody complexes. We summarise early clinical results from studies utilising these treatments, which include the immuno-oncology treatment AMG 420 (BiTE®, "bispecific T-cell engager"), the antibody-drug combination GSK2857916, and other CAR T-cell therapeutic agents such as bb2121, NIH CAR-BCMA, and LCAR-B38M. The minimal residual disease negativity rates are high, and several of these treatments have shown notable antimyeloma activity. The promise of BCMA-targeted treatments for MM is highlighted by these clinical data. Importantly, preliminary clinical data indicate that these treatments have the potential to provide deep and long-lasting effects, which bodes well for future research into early therapy modalities, such as those for newly diagnosed MM.