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GPRC5D × CD3 bispecific antibodies represent a class of T-cell redirecting immunotherapies primarily developed for the treatment of multiple myeloma. These biologics are engineered to simultaneously bind to two distinct targets: G protein-coupled receptor family C group 5 member D (GPRC5D), which is highly and selectively expressed on malignant plasma cells, and the CD3 receptor on the surface of T cells. By bridging these two cell types, the antibody facilitates the formation of an immunological synapse, leading to T-cell activation and the subsequent release of cytotoxic proteins (such as perforin and granzymes) that induce lysis of the myeloma cells. GPRC5D is considered an ideal therapeutic target due to its high expression in approximately 90% of multiple myeloma patients and its very limited expression in normal tissues, restricted mainly to hard keratinized structures like hair and nails. Talquetamab (Talvey) is the first-in-class agent in this category to receive regulatory approval.
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