Targeting BCMA in Multiple Myeloma: Advances in Antibody-Drug Conjugate Therapy

• Published in: Cancers Vol. 15; no. 8; p. 2240
• Main Authors: Xing, Lijie, Liu, Yuntong, Liu, Jiye
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01.04.2023; MDPI
• Subjects: Anti-BCMA ADC; Antibodies; Antibody-drug conjugates; Antigens; Apoptosis; B cell maturation antigen; B cells; Biopharmaceutics; Bone marrow; Cancer; Cell differentiation; Cell growth; Cell proliferation; Cell survival; Chemotherapy; Clinical trials; Cytotoxic agents; Cytotoxicity; DNA damage; Dosage and administration; drug resistance; Drug targeting; Drug therapy; Health aspects; Immune system; Immunosuppressive agents; Immunotherapy; Lymphocytes; Lymphocytes B; Medical prognosis; Methods; Multiple myeloma; Patients; Plasma; Plasma cells; Review; Viral antibodies; China; Anti-BCMA ADC; multiple myeloma; drug resistance; B cell maturation antigen; antibody-drug conjugates
• ISSN: 2072-6694; 2072-6694
• DOI: 10.3390/cancers15082240

Multiple myeloma (MM) is an incurable cancer of the plasma cells. In the last twenty years, treatment strategies have evolved toward targeting MM cells-from the shotgun chemotherapy approach to the slightly more targeted approach of disrupting important MM molecular pathways to the immunotherapy approach that specifically targets MM cells based on protein expression. Antibody-drug conjugates (ADCs) are introduced as immunotherapeutic drugs which utilize an antibody to deliver cytotoxic agents to cancer cells distinctively. Recent investigations of ADCs for MM treatment focus on targeting B cell maturation antigen (BCMA), which regulates B cell proliferation, survival, maturation, and differentiation into plasma cells (PCs). Given its selective expression in malignant PCs, BCMA is one of the most promising targets in MM immunotherapy. Compared to other BCMA-targeting immunotherapies, ADCs have several benefits, such as lower price, shorter production period, fewer infusions, less dependence on the patient's immune system, and they are less likely to over-activate the immune system. In clinical trials, anti-BCMA ADCs have shown safety and remarkable response rates in patients with relapsed and refractory MM. Here, we review the properties and clinical applications of anti-BCMA ADC therapies and discuss the potential mechanisms of resistance and ways to overcome them.