Teclistamab-cqyv: The First Bispecific T-Cell Engager Antibody for the Treatment of Patients With Relapsed or Refractory Multiple Myeloma

Abstract

Multiple myeloma (MM) remains an incurable malignancy originating from plasma cells. Despite significant advances in treatment, relapses remain inevitable, and novel therapies continue to be needed. Teclistamab-cqyv is a first-in-class, bispecific T-cell engager (BiTE) antibody for the treatment of MM. Teclistamab-cqyv activates the immune system by binding to the cluster of differentiation 3 (CD3) receptor expressed on the surface of T cells and to the B-cell maturation antigen (BCMA) expressed on the surface of MM cells and some healthy B-lineage cells. Teclistamab-cqyv has been shown to be effective in a pivotal trial that demonstrated an overall response rate of more than 60% in heavily pretreated patients. Compared with other BCMA-targeted agents, the side effect profile of teclistamab-cqyv suggests a more tolerable option for elderly patients. Teclistamab-cqyv is now approved by the US Food and Drug Administration (FDA) as monotherapy for the treatment of adult patients with relapsed or refractory MM.

Bispecific antibodies in hematological malignancies

“…For the multiple myeloma treatment, Teclistamab (Tecvidli®) is a BsAb developed to simultaneously recognize and bind to two targets: B cell maturation antigen (BCMA) on myeloma cells and CD3 on the T cells surface ( immune system cells). By binding to these target proteins, this drug engages cancer cells and T cells, leading to activation of T cells and lysis of myeloma cells, thereby eliminating multiple myeloma cells (Usmani et al, 2021;Moreau et al, 2022;Hua et al, 2023). This targeting of BCMA is effective because it is overexpressed and activated in multiple myeloma and is mediated by the performance and certain granzymes from cytotoxic T cells secretion (Kleber et al, 2021;Girgis et al, 2022).…”

“…Para o tratamento do mieloma múltiplo, o Teclistamab (Tecvayli ® ) é um BsAbs desenvolvido para reconhecer e se ligar simultaneamente a dois alvos: o antígeno de maturação das células B (BCMA) nas células do mieloma e o CD3 na superfície das células T (células do sistema imunológico). Ao se ligar a essas proteínas-alvo, esse medicamento envolve células cancerígenas e células T, levando à ativação das células T e à lise das células do mieloma, eliminando assim as células do mieloma múltiplo (Usmani et al, 2021;Moreau et al, 2022;Hua et al, 2023). Esse direcionamento ao BCMA é eficaz, pois está superexpresso e ativado no mieloma múltiplo, e é mediada pela secreção de perforina e certas granzimas de células T citotóxicas (Kleber et al, 2021;Girgis et al, 2022).…”