Dr. Usmani on CAR T Cells, Bispecific Antibodies, and ADCs in Multiple Myeloma

Saad Z. Usmani, MD, FACP, chief of Plasma Cell Disorder, director of Clinical Research in Hematologic Malignancies, Levine Cancer Institute, Atrium Health, discusses the mechanisms of action of BCMA-targeted CAR T-cell therapy, bispecific monoclonal antibodies, and antibody-drug conjugates (ADCs) in multiple myeloma.

BCMA-targeted CAR T cells modify the immune system by activating a patient’s own T cells to recognize BCMA, a surface marker on myeloma cells. As the T cells proliferate, they attack cells expressing BCMA. Using a more specific target for CAR T-cell therapy will yield a more favorable outcome for the patient, adds Usmani.

Bispecific monoclonal antibodies can also target BCMA. One arm of the agent targets BCMA, while the other latches to CD3 on the T cell. Then, the T cell can effectively kill the myeloma cell.

A third strategy is the use of ADCs in which a cytotoxic payload, attached to an antibody, is delivered to the cancer cell. Once the toxin has been internalized, it is released, resulting in cell death.