A CD38/CD3xCD28 trispecific T-cell engager as a potentially active agent in multiple myeloma patients relapsed and/or refractory to anti-CD38 monoclonal antibodies

Br J Haematol. 2024 Dec;205(6):2262-2267. doi: 10.1111/bjh.19784. Epub 2024 Sep 22.

Abstract

There is accumulating evidence of BCMA and GPRC5D loss after treatment with T-cell redirecting therapies in patients with relapsed/refractory multiple myeloma (RRMM). While complete CD38 loss is not observed upon relapses after treatment with anti-CD38 monoclonal antibodies (mAb), there is downregulation of surface CD38 expression and decreased number and function of NK cells, which renders these patients resistant to retreatment with anti-CD38 mAb. Here, we provide preclinical evidence that RRMM patients previously exposed to anti-CD38 mAb could benefit from T-cell-based immunotherapy that depend less on CD38 antigen density and NK-cell activity, such as the novel CD38/CD3xCD28 trispecific T-cell engager, SAR442257.

Keywords: CD38; T‐cell engager; antibody therapy; relapsed/refractory multiple myeloma; resistance to anti‐CD38 monoclonal antibodies.

MeSH terms

  • ADP-ribosyl Cyclase 1* / antagonists & inhibitors
  • ADP-ribosyl Cyclase 1* / immunology
  • Antibodies, Monoclonal / therapeutic use
  • CD3 Complex / immunology
  • Drug Resistance, Neoplasm
  • Humans
  • Killer Cells, Natural / drug effects
  • Killer Cells, Natural / immunology
  • Membrane Glycoproteins
  • Multiple Myeloma* / drug therapy
  • Multiple Myeloma* / immunology
  • Multiple Myeloma* / therapy
  • Recurrence
  • T-Lymphocytes* / immunology

Substances

  • ADP-ribosyl Cyclase 1
  • CD38 protein, human
  • CD3 Complex
  • Antibodies, Monoclonal
  • Membrane Glycoproteins