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A BCMAxCD3 bispecific is a therapeutic modality belonging to the class of T-cell engagers (TCEs), specifically designed for the treatment of multiple myeloma. These molecules are engineered with two distinct binding domains: one targeting the B-cell maturation antigen (BCMA), which is highly and selectively expressed on the surface of malignant plasma cells, and another targeting the CD3 epsilon subunit of the T-cell receptor complex. By physically bridging T cells and myeloma cells, these bispecific antibodies trigger T-cell activation, degranulation, and the release of cytotoxic proteins (such as perforin and granzymes), leading to the direct lysis of the target cancer cells independent of major histocompatibility complex (MHC) recognition. Several agents in this category, including teclistamab and elranatamab, have demonstrated significant clinical efficacy and have been approved for patients with relapsed or refractory multiple myeloma.
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