Role of Anti-B-Cell Maturation Antigen (BCMA) in the Management of Multiple Myeloma
Abstract
:Simple Summary
Abstract
1. Introduction
2. Multiple Myeloma
2.1. Burden of Disease
2.2. Pathogenesis
2.3. Therapy
3. Role of BCMA in MM Pathogenesis
4. Anti-BCMA
5. BCMA-ADC (Antibody-Drug Conjugate)
6. Bispecific T-Cell Engager (BiTEs)
7. Chimeric Antigen Receptor (CAR) T Cells
8. Comparison of the Mechanism of Action to Currently Available Therapies
Mechanism of Action
9. Anti-BCMA Potential for Multiple Myeloma
10. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Class | Drugs | Target of Action | Mechanism of Action | Reported Toxicities | Indication |
---|---|---|---|---|---|
Proteasome inhibitor | Bortezomib Carfilzomib Ixazomib | Proteasomes of malignant plasma cells | Inhibition of IκBα (classical pathway) degradation in proteasome [11,22]; Activation of JNK pathway and caspases [11,22]; Inhibition of pro-apoptotic protein degradation [11,22] | Peripheral neuropathy, nausea, vomiting, diarrhea, cytopenia, infection, fatigue, headache, peripheral edema, and back pain [23,24] | Initial induction therapy (bortezomib) [13,23,24]; Recurrent/relapsed therapy (carfilzomib, ixazomib) [23,24]. |
Immunomodulators | Thalidomide Lenalidomide | B and T lymphocytes Malignant plasma cells | Augmentation of T-cell costimulation [25]; Inhibition of plasma-cell-derived cytokines [25]; Inhibition of T-regulator proliferation and suppressor function [25]; Increasing NK- and NKT-cell proliferation in IL2- and IFN-gamma milieu [25]; Direct cytotoxicity to malignant cells through apoptosis pathways [26] | Cytopenia, infection, fatigue, and peripheral neuropathy [27]; Deep-vein thrombosis (in combination with dexamethasone [27] | Induction and maintenance therapy [25,26]; Recurrent/relapsed [25,26] |
Monoclonal antibodies | Daratumumab Elotuzumab | Surface antigens of malignant plasma cells, CD38 (daratumumab), and CS1/SLAMF7 (elotuzumab) | Antibody-dependent cellular cytotoxicity [28,29]; Complement-dependent cellular cytotoxicity [28,29] | Induction therapy [13]; Recurrent/relapsed MM [24,27] | |
Anti-BCMA | ADC (belantamab mafodotin) | BCMA | Coupling to MMFA [20,22]; Direct cytotoxicity [20,22] | Thrombocytopenia, anemia, and corneal events [30] | Recurrent/relapsed MM [13] |
BiTEs | BCMA | Binding to T cells and induction of apoptosis through perforin [20,22]; Direct cytotoxicity [20,22] | No serious adverse events reported yet [31] | ||
CAR T cells | BCMA | Conversion of patient-derived cytotoxic T cells into specific killers of cancer cells using recombinant DNA mutation process [25,26] | Neurotoxicity, nephrotoxicity [32] |
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Rinaldi, I.; Muthalib, A.; Edina, B.C.; Wiyono, L.; Winston, K. Role of Anti-B-Cell Maturation Antigen (BCMA) in the Management of Multiple Myeloma. Cancers 2022, 14, 3507. https://doi.org/10.3390/cancers14143507
Rinaldi I, Muthalib A, Edina BC, Wiyono L, Winston K. Role of Anti-B-Cell Maturation Antigen (BCMA) in the Management of Multiple Myeloma. Cancers. 2022; 14(14):3507. https://doi.org/10.3390/cancers14143507
Chicago/Turabian StyleRinaldi, Ikhwan, Abdul Muthalib, Brenda Cristie Edina, Lowilius Wiyono, and Kevin Winston. 2022. "Role of Anti-B-Cell Maturation Antigen (BCMA) in the Management of Multiple Myeloma" Cancers 14, no. 14: 3507. https://doi.org/10.3390/cancers14143507