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BCMA-targeting T-cell redirecting bispecific antibodies are a class of immunotherapeutic agents designed to treat multiple myeloma by simultaneously binding B-cell maturation antigen (BCMA) on malignant plasma cells and CD3 on T-cells. This dual binding redirects and activates cytotoxic T-cells to recognize and kill BCMA-expressing multiple myeloma cells through mechanisms including the release of granzymes and perforins. These agents can be constructed as BiTEs (bispecific T-cell engagers) or full-length IgG-like molecules with Fc domains, which influence their half-life and dosing schedules. They have shown pronounced activity in heavily pretreated relapsed/refractory multiple myeloma patients, with overall response rates around 60-70%. The most common adverse event is cytokine release syndrome, manageable with tocilizumab or steroids. Several clinical candidates include teclistamab, AMG420/AMG701, CC-93269/alnuctamab, linvoseltamab/REGN5458, elranatamab/PF-3135 among others. Combination therapies with immunomodulatory drugs or CD38-targeted antibodies are under investigation to enhance efficacy[1][2][3][4][5].
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