Department of Internal Medicine, Saint Michael's Medical Center, Newark, NJ, USA.
Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Expert Rev Anticancer Ther. 2024 May;24(5):229-238. doi: 10.1080/14737140.2024.2343114. Epub 2024 Apr 16.
The prognosis of multiple myeloma (MM) continues to improve. Recent progress in therapies, using immunomodulatory drugs (IMiDs), proteasome inhibitors (PIs), and anti-CD38 monoclonal antibodies, has greatly improved patients' outcomes. Despite these advancements, relapses still happen often, and patients can become resistant to the usual treatments. Newer treatments, such as chimeric antigen receptor (CAR) T-cell therapy and bispecific antibodies (BsAbs) targeting B-cell maturation antigen (BCMA), have resulted in excellent outcomes in patients with limited treatment options. G protein - coupled receptor, class C group 5 member D (GPRC5D) is considered a very promising target with early results from clinical trials showing high response rates in patients with relapsed or refractory multiple myeloma.
This review covers the efficacy and safety of CAR-T and BsAbs targeting GPRC5D in MM, focusing on talquetamab - the inaugural FDA-approved BsAb targeting GPRC5D. Talquetamab has exhibited promising response rates alongside a distinctive side effect profile. Additionally, ongoing trials examining talquetamab in combination with agents like daratumumab and teclistamab are discussed.
We offer insights into the potential utilization of various GPRC5D-based therapies in the treatment paradigm for MM, either independently or in combination with established therapies.
多发性骨髓瘤(MM)的预后仍在改善。免疫调节药物(IMiDs)、蛋白酶体抑制剂(PIs)和抗 CD38 单克隆抗体等疗法的最新进展极大地改善了患者的预后。尽管取得了这些进展,但复发仍然经常发生,患者可能对常规治疗产生耐药。新型治疗方法,如嵌合抗原受体(CAR)T 细胞疗法和针对 B 细胞成熟抗原(BCMA)的双特异性抗体(BsAbs),在治疗选择有限的患者中取得了极好的疗效。G 蛋白偶联受体,C 类组 5 成员 D(GPRC5D)被认为是一个非常有前途的靶点,临床试验的早期结果显示,复发或难治性多发性骨髓瘤患者的反应率很高。
本文综述了 CAR-T 和针对 GPRC5D 的 BsAbs 在 MM 中的疗效和安全性,重点介绍了 talquetamab——首个获得 FDA 批准的针对 GPRC5D 的 BsAb。talquetamab 表现出有希望的反应率,同时具有独特的副作用特征。此外,还讨论了正在进行的试验,研究 talquetamab 与达雷木单抗和 teclistamab 等药物联合使用的情况。
我们深入探讨了各种基于 GPRC5D 的疗法在 MM 治疗方案中的潜在应用,无论是独立使用还是与现有疗法联合使用。