Dr. Holstein on BiTEs in Multiple Myeloma

Sarah Holstein, MD, PhD, associate professor of medicine, University of Nebraska Medical Center, discusses the emergence of bispecific T-cell engagers (BiTEs) in multiple myeloma.

There is much excitement surrounding AMG 420, which is the first BiTE candidate in multiple myeloma, says Holstein. In a phase I study evaluating AMG 420, 7 of 10 patients with heavily pretreated multiple myeloma who were administered a 400-µg/day dose responded to the therapy; 4 patients achieved a complete response (CR). Moreover, the 4 patients with CRs and 1 patient who achieved a partial response had no minimal residual disease. The BiTE candidate binds to the antigen BCMA that is expressed on multiple myeloma cells, which makes it a viable candidate worth pursuing in the space.

The idea behind these engagers is to take the antigen recognition part of an antibody that identifies BCMA on the surface of myeloma cells and an antibody recognizing CD3 on a T cell. Through this recognition, the 2 antibodies hook together, which allows the T cell to be brought to the myeloma cell. As a result, cytotoxic T cells are brought directly to the target cancer cell, explains Holstein.