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GPRC5D CAR-T cell therapy is an adoptive cellular immunotherapy designed to treat multiple myeloma by targeting the G protein-coupled receptor class C group 5 member D (GPRC5D). GPRC5D is an orphan receptor highly and specifically expressed on malignant plasma cells, with limited expression in normal tissues such as hair follicles and the keratinized epithelium of the tongue. This therapy involves engineering a patient's T cells to express a chimeric antigen receptor (CAR) that recognizes GPRC5D, enabling the T cells to identify and eliminate myeloma cells. This modality is particularly significant for patients who have relapsed after or are refractory to BCMA-targeted therapies, as GPRC5D provides an independent antigenic target. Clinical candidates like BMS-986393 and OriCAR-017 have demonstrated high response rates in heavily pretreated populations, although they are associated with unique on-target, off-tumor toxicities including skin changes, nail dystrophy, and dysgeusia.
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