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BCMA mono-specific CAR-T cell therapy is a type of adoptive cellular immunotherapy designed to target the B-cell maturation antigen (BCMA), a protein highly expressed on the surface of malignant plasma cells in multiple myeloma. These therapies involve the genetic modification of T cells to express a chimeric antigen receptor (CAR) that specifically binds to BCMA, triggering T-cell activation and the subsequent destruction of the tumor cells. While this class of therapy has shown significant clinical success, leading to the approval of agents like idecabtagene vicleucel and ciltacabtagene autoleucel, it faces challenges such as antigen escape (loss or downregulation of BCMA), T-cell exhaustion, and the inhibitory presence of soluble BCMA in the serum, which can contribute to disease relapse. Clinical studies have demonstrated that BCMA CAR-T therapies often provide superior efficacy compared to BCMA-directed T-cell engagers (TCE) or antibody-drug conjugates (ADC), particularly in high-risk patients.
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