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BCMA x CD3 bispecific T-cell engagers (BiTEs) represent a potent class of immunotherapy primarily utilized in the treatment of relapsed or refractory multiple myeloma. These molecules are engineered with two distinct binding domains: one specific to the B-cell maturation antigen (BCMA), which is highly and selectively expressed on the surface of malignant plasma cells, and another specific to the CD3 epsilon subunit of the T-cell receptor complex. By physically bridging cytotoxic T cells and tumor cells, these agents bypass the need for traditional major histocompatibility complex (MHC) class I antigen presentation, triggering T-cell activation, degranulation, and the release of perforins and granzymes to induce apoptosis in the target myeloma cells. Several agents in this class, such as teclistamab and elranatamab, have received regulatory approval, demonstrating significant clinical efficacy in heavily pretreated patient populations.
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