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GPRC5D CAR T cells are an investigational class of cellular immunotherapies engineered to target the G protein-coupled receptor, class C group 5 member D (GPRC5D), which is highly and selectively expressed on malignant plasma cells in multiple myeloma. This modality involves the genetic modification of T cells (either autologous from the patient or allogeneic from a healthy donor) to express a chimeric antigen receptor (CAR) that recognizes GPRC5D. Upon binding to the target antigen, the CAR T cells undergo activation, expansion, and mediate the cytotoxic destruction of the myeloma cells. GPRC5D has emerged as a critical alternative target to BCMA, particularly for patients who have relapsed after BCMA-directed therapies. Current development efforts include allogeneic off-the-shelf versions, such as those by Sana Biotechnology, which utilize hypoimmune (HIP) modifications to evade host immune rejection through gene disruption (TCR, B2M, CIITA) and CD47 overexpression.
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