Teclistamab
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Teclistamab is a bispecific B-cell maturation antigen (BCMA)-directed CD3 T cell engager used to treat relapsed and refractory multiple myeloma in adults as monotherapy.
Teclistamab is a bispecific B-cell maturation antigen (BCMA)-directed CD3 T cell engager used to treat relapsed and refractory multiple myeloma in adults as monotherapy.
B-cell maturation antigen (BCMA) is a member of the tumour necrosis factor family of receptors expressed on the surface of B-lineage cells, as well as late-stage B cells and plasma cells. BCMA interacts with its ligands to activate survival signalling pathways such as NF-kappa B, STAT3, ERK1/2, and AKT/PI3K, and upregulates anti-apoptotic proteins to regulate B-cell maturation, proliferation, and survival. Besides B cells, BCMA is also widely expressed on multiple myeloma (MM) cells and supports the survival of MM cells, making it a promising therapeutic target for therapeutic agents for MM. Teclistamab is a bispecific T cell engaging antibody that targets the CD3 receptor, which is expressed on the surface of T cells, and BCMA, which is expressed on malignant cells. Due to its dual binding sites, teclistamab is able to draw CD3 T cells in close proximity to BCMA cells, resulting in T cell activation and T cell-mediated cytotoxicity, which is mediated by secreted perforin and various granzymes stored in the secretory vesicles of cytotoxic T cells. This effect occurs without regard to T cell receptor specificity or reliance on major histocompatibility complex (MHC) Class 1 molecules on the surface of antigen presenting cells. Ultimately, teclistamab promotes the lysis and death of BCMA cells.
Teclistamab is indicated as monotherapy for the treatment of adult patients with relapsed and refractory multiple myeloma who have received at least three prior therapies, including an immunomodulatory agent, a proteasome inhibitor, and an anti-CD38 antibody and have demonstrated disease progression on the last therapy. Teclistamab is approved by the EC and FDA under conditional marketing authorization and accelerated approval, respectively. New evidence for this drug will be continuously monitored and reviewed, which will affect continued approval for the drug's indication.
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