How Bispecific Antibodies Work to Treat Patients With Multiple Myeloma

Dr. Amany Keruakous sat down for an interview with CURE, in which she discussed how bispecific antibodies for multiple myeloma work by simultaneously targeting cancer cells and T cells, enabling the immune system to attack the myeloma. She also explained the risks, emphasizing the importance of careful monitoring during treatment.

Keruakous is the director of Myeloma Research at Georgia Cancer Center and an assistant professor in the Department of Medicine, Hematology and Oncology, at the Medical College of Georgia. She also serves as associate director of the Hematology-Oncology Fellowship Program at Georgia Cancer Center.

Transcript

How do bispecific antibodies work, and what potential benefits might they offer compared with traditional treatments?

In our bodies, there are antibodies that fight infections. For you, how they fight infection is by recognizing an abnormal cell, let's say a myeloma cancer cell. When they recognize this cell, they sit on the top of it and then trigger an alarm system, so the rest of your immune system comes and kills this cell. However, multiple myeloma cells are very smart. They can resist this mechanism.

What we have learned from the human immune system is that we can actually manufacture those antibodies and have them target a specific marker on the myeloma cell. These antibodies are Y-shaped antibodies, but how is it manufactured? One arm is actually labeled to recognize a specific cell marker that is expressed on your myeloma cells, such as BCMA or GPRC5D, and the other arm is labeled to target CD3, which is a marker that is expressed on your normal lymphocyte T cells.

These antibodies, when they're infused into the patient’s body, grab one of the T cells along with one of the myeloma cells and let them fight together. That's why you end up with this exaggerated inflammatory response, which is what we call cytokine release syndrome (CRS), and that can affect the central nervous system and cause neurotoxicity.

Transcript has been edited for clarity and conciseness.

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