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Tacchetti P, Talarico M, Barbato S, Pantani L, Mancuso K, Rizzello I, Zamagni E, Cavo M. Antibody-drug conjugates, bispecific antibodies and CAR-T cells therapy in multiple myeloma. Expert Rev Anticancer Ther 2024; 24:379-395. [PMID: 38798125 DOI: 10.1080/14737140.2024.2344647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 04/15/2024] [Indexed: 05/29/2024]
Abstract
INTRODUCTION Modern immunotherapy approaches are revolutionizing the treatment scenario of relapsed/refractory (RR) multiple myeloma (MM) patients, providing an opportunity to reach deep level of responses and extend survival outcomes. AREAS COVERED Antibody-drug conjugates (ADCs) and T-cell redirecting treatments, including bispecific antibodies (BsAbs) and chimeric antigen receptor (CAR) T cells therapy, have been recently introduced in the treatment of RRMM. Some agents have already received regulatory approval, while newer constructs, novel combinations, and applications in earlier lines of therapy are currently being explored. This review discusses the current landscape and possible development of ADCs, BsAbs and CAR-T cells immunotherapies. EXPERT OPINION ADCs, BsAbs, and CAR-T therapy have demonstrated substantial activity in heavily pretreated, triple-class exposed (TCE) MM patients, and T-cell redirecting treatments represent new standards of care after third (European Medicines Agency, EMA), or fourth (Food and Drug Administration, FDA), line of therapy. All these three immunotherapies carry advantages and disadvantages, with different accessibility and new toxicities that require appropriate management and guidelines. Multiple on-going programs include combinations therapies and applications in earlier lines of treatment, as well as the development of novel agents or construct to enhance potency, reduce toxicity and facilitate administration. Sequencing is a challenge, with few data available and mechanisms of resistance still to be unraveled.
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Affiliation(s)
- Paola Tacchetti
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
| | - Marco Talarico
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Simona Barbato
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Lucia Pantani
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
| | - Katia Mancuso
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Ilaria Rizzello
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Elena Zamagni
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Michele Cavo
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
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Brudno JN, Kochenderfer JN. Current understanding and management of CAR T cell-associated toxicities. Nat Rev Clin Oncol 2024:10.1038/s41571-024-00903-0. [PMID: 38769449 DOI: 10.1038/s41571-024-00903-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2024] [Indexed: 05/22/2024]
Abstract
Chimeric antigen receptor (CAR) T cell therapy has revolutionized the treatment of several haematological malignancies and is being investigated in patients with various solid tumours. Characteristic CAR T cell-associated toxicities such as cytokine-release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) are now well-recognized, and improved supportive care and management with immunosuppressive agents has made CAR T cell therapy safer and more feasible than it was when the first regulatory approvals of such treatments were granted in 2017. The increasing clinical experience with these therapies has also improved recognition of previously less well-defined toxicities, including movement disorders, immune effector cell-associated haematotoxicity (ICAHT) and immune effector cell-associated haemophagocytic lymphohistiocytosis-like syndrome (IEC-HS), as well as the substantial risk of infection in patients with persistent CAR T cell-induced B cell aplasia and hypogammaglobulinaemia. A more diverse selection of immunosuppressive and supportive-care pharmacotherapies is now being utilized for toxicity management, yet no universal algorithm for their application exists. As CAR T cell products targeting new antigens are developed, additional toxicities involving damage to non-malignant tissues expressing the target antigen are a potential hurdle. Continued prospective evaluation of toxicity management strategies and the design of less-toxic CAR T cell products are both crucial for ongoing success in this field. In this Review, we discuss the evolving understanding and clinical management of CAR T cell-associated toxicities.
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Affiliation(s)
- Jennifer N Brudno
- Surgery Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
| | - James N Kochenderfer
- Surgery Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
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Rodriguez-Otero P, Usmani S, Cohen AD, van de Donk NWCJ, Leleu X, Pérez-Larraya JG, Manier S, Nooka AK, Mateos MV, Einsele H, Minnema M, Cavo M, Derman BA, Puig N, Gay F, Ho PJ, Chng WJ, Kastritis E, Gahrton G, Weisel K, Nagarajan C, Schjesvold F, Mikhael J, Costa L, Raje NS, Zamagni E, Hájek R, Weinhold N, Yong K, Ye JC, Sidhana S, Merlini G, Martin T, Lin Y, Chari A, Popat R, Kaufman JL. International Myeloma Working Group immunotherapy committee consensus guidelines and recommendations for optimal use of T-cell-engaging bispecific antibodies in multiple myeloma. Lancet Oncol 2024; 25:e205-e216. [PMID: 38697166 DOI: 10.1016/s1470-2045(24)00043-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 01/17/2024] [Accepted: 01/22/2024] [Indexed: 05/04/2024]
Abstract
Multiple myeloma remains an incurable disease, despite the development of numerous drug classes and combinations that have contributed to improved overall survival. Immunotherapies directed against cancer cell-surface antigens, such as chimeric antigen receptor (CAR) T-cell therapy and T-cell-redirecting bispecific antibodies, have recently received regulatory approvals and shown unprecedented efficacy. However, these immunotherapies have unique mechanisms of action and toxicities that are different to previous treatments for myeloma, so experiences from clinical trials and early access programmes are essential for providing specific recommendations for management of patients, especially as these agents become available across many parts of the world. Here, we provide expert consensus clinical practice guidelines for the use of bispecific antibodies for the treatment of myeloma. The International Myeloma Working Group is also involved in the collection of prospective real-time data of patients treated with such immunotherapies, with the aim of learning continuously and adapting clinical practices to optimise the management of patients receiving immunotherapies.
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Affiliation(s)
| | - Saad Usmani
- Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, NY, USA
| | - Adam D Cohen
- University of Pennsylvania, Philadelphia, Pennsylvania, PA, USA
| | | | - Xavier Leleu
- Centre Hospitalier Universitaire Poitiers, Poitiers, France
| | - Jaime Gállego Pérez-Larraya
- Department of Neurology, Clínica Universidad de Navarra, Cancer Center Clinica Universidad de Navarra, CCUN, Pamplona, Spain
| | - Salomon Manier
- Centre Hospitalier Universitaire Lille, Universite de Lille, Lille, France
| | - Ajay K Nooka
- Department of Hematology and Medical Oncology, Winship Cancer Institute, School of Medicine, Emory University, Atlanta, GA, USA
| | - Maria Victoria Mateos
- University Hospital of Salamanca/IBSAL/Cancer Research Center-IBMCC (USAL-CSIC), CIBERONC, Salamanca, Spain
| | - Hermann Einsele
- Universitätsklinikum Würzburg, Department of Internal Medicine II, Würzburg, Germany
| | - Monique Minnema
- Department of Hematology, University Medical Center, Utrecht, Netherlands
| | - Michele Cavo
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy; Dipartimento di Scieze Mediche e Chirurgiche, Universitá di Bologna, Bologna, Italy
| | - Benjamin A Derman
- Section of Hematology/Oncology, University of Chicago, Chicago, IL, USA
| | - Noemi Puig
- University Hospital of Salamanca/IBSAL/Cancer Research Center-IBMCC (USAL-CSIC), CIBERONC, Salamanca, Spain
| | - Francesca Gay
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza, Torino, Italy
| | - P Joy Ho
- Royal Prince Alfred Hospital and University of Sydney, Sydney, NSW, Australia
| | - Wee-Joo Chng
- Department of Hematology-Oncology, National University Cancer Institute, Singapore
| | - Efstathios Kastritis
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Gösta Gahrton
- Department of Medicine, Karolinska Institutet, Huddinge, Stockholm, Sweden
| | - Katja Weisel
- Universitätsklinikum Hamburg-Eppendorf, Medizinische Klinik und Poliklinik, Hamburg, Germany
| | - Chandramouli Nagarajan
- Department of Haematology, Singapore General Hospital and SingHealth Duke NUS Blood Cancer Center, Singapore
| | - Fredik Schjesvold
- Oslo Myeloma Center, Department of Hematology, Oslo University Hospital, Oslo, Norway; KG Jebsen Center for B Cell Malignancies, University of Oslo, Oslo, Norway
| | - Joseph Mikhael
- Translational Genomics Research Institute, City of Hope Cancer Center, Phoenix, AZ, USA; International Myeloma Foundation, Studio City, CA, USA
| | - Luciano Costa
- Department of Medicine, Division of Hematology and Oncology, University of Wisconsin, Madison, WI, USA
| | - Noopur S Raje
- Department of Medical Oncology, Massachusetts General Hospital, Boston, MA, USA
| | - Elena Zamagni
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", Bologna, Italy; Dipartimento di Scieze Mediche e Chirurgiche, Universitá di Bologna, Bologna, Italy
| | - Roman Hájek
- Department of Hemato-oncology, University Hospital Ostrava, Ostrava, Czech Republic
| | - Niels Weinhold
- Department of Medicine V, Multiple Myeloma Section, University Hospital Heidelberg, Heidelberg, Germany
| | - Kwee Yong
- University College London Hospitals, London, UK
| | | | - Surbhi Sidhana
- Stanford University School of Medicine, Stanford, CA, USA
| | - Giampaolo Merlini
- Amyloidosis Research and Treatment Center, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Tom Martin
- UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
| | - Yi Lin
- Mayo Clinic, Rochester, MN, USA
| | - Ajai Chari
- UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
| | - Rakesh Popat
- NIHR UCLH Clinical Research Facility, University College London Hospitals NHS Foundation Trust, London, UK
| | - Jonathan L Kaufman
- Department of Hematology and Medical Oncology, Winship Cancer Institute, School of Medicine, Emory University, Atlanta, GA, USA
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Elemian S, Al Hadidi S. Targeting GPRC5D in multiple myeloma. Expert Rev Anticancer Ther 2024; 24:229-238. [PMID: 38607646 DOI: 10.1080/14737140.2024.2343114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 04/10/2024] [Indexed: 04/13/2024]
Abstract
INTRODUCTION The prognosis of multiple myeloma (MM) continues to improve. Recent progress in therapies, using immunomodulatory drugs (IMiDs), proteasome inhibitors (PIs), and anti-CD38 monoclonal antibodies, has greatly improved patients' outcomes. Despite these advancements, relapses still happen often, and patients can become resistant to the usual treatments. Newer treatments, such as chimeric antigen receptor (CAR) T-cell therapy and bispecific antibodies (BsAbs) targeting B-cell maturation antigen (BCMA), have resulted in excellent outcomes in patients with limited treatment options. G protein - coupled receptor, class C group 5 member D (GPRC5D) is considered a very promising target with early results from clinical trials showing high response rates in patients with relapsed or refractory multiple myeloma. AREAS COVERED This review covers the efficacy and safety of CAR-T and BsAbs targeting GPRC5D in MM, focusing on talquetamab - the inaugural FDA-approved BsAb targeting GPRC5D. Talquetamab has exhibited promising response rates alongside a distinctive side effect profile. Additionally, ongoing trials examining talquetamab in combination with agents like daratumumab and teclistamab are discussed. EXPERT OPINION We offer insights into the potential utilization of various GPRC5D-based therapies in the treatment paradigm for MM, either independently or in combination with established therapies.
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Affiliation(s)
- Shatha Elemian
- Department of Internal Medicine, Saint Michael's Medical Center, Newark, NJ, USA
| | - Samer Al Hadidi
- Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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Cech P, Skórka K, Dziki L, Giannopoulos K. T-Cell Engagers-The Structure and Functional Principle and Application in Hematological Malignancies. Cancers (Basel) 2024; 16:1580. [PMID: 38672662 PMCID: PMC11048836 DOI: 10.3390/cancers16081580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 04/17/2024] [Accepted: 04/18/2024] [Indexed: 04/28/2024] Open
Abstract
Recent advancements in cancer immunotherapy have made directing the cellular immune response onto cancer cells a promising strategy for the treatment of hematological malignancies. The introduction of monoclonal antibody-based (mAbs) targeted therapy has significantly improved the prognosis for hematological patients. Facing the issues of mAb-based therapies, a novel bispecific antibody (BsAb) format was developed. T-cell engagers (TCEs) are BsAbs, which simultaneously target tumor-associated antigens on tumor cells and CD3 molecules present on T-cells. This mechanism allows for the direct activation of T-cells and their anti-tumor features, ultimately resulting in the lysis of tumor cells. In 2014, the FDA approved blinatumomab, a TCE directed to CD3 and CD19 for treatment of acute lymphoblastic leukemia. Since then, numerous TCEs have been developed, allowing for treating different hematological malignancies such as acute myeloid leukemia, multiple myeloma, and non-Hodgkin lymphoma and Hodgkin lymphoma. As of November 2023, seven clinically approved TCE therapies are on the market. TCE-based therapies still have their limitations; however, improving the properties of TCEs, as well as combining TCE-based therapies with other forms of treatment, give hope to find the cures for currently terminal diseases. In this paper, we summarized the technical basis of the TCE technology, its application in hematology, and its current issues and prospects.
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Affiliation(s)
| | - Katarzyna Skórka
- Department of Experimental Hematooncology, Medical University of Lublin, 20-093 Lublin, Poland; (P.C.); (L.D.); (K.G.)
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6
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Parrondo RD, Ailawadhi S, Cerchione C. Bispecific antibodies for the treatment of relapsed/refractory multiple myeloma: updates and future perspectives. Front Oncol 2024; 14:1394048. [PMID: 38660139 PMCID: PMC11039948 DOI: 10.3389/fonc.2024.1394048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 03/26/2024] [Indexed: 04/26/2024] Open
Abstract
Patients with relapsed/refractory multiple myeloma (RRMM) that are refractory to the five most active anti-MM drugs, so-called penta-refractory MM, have historically had dismal outcomes with subsequent therapies. Progressive immune dysfunction, particularly of the T-cell repertoire, is implicated in the development of disease progression and refractory disease. However, the advent of novel immunotherapies such as bispecific antibodies are rapidly changing the treatment landscape and improving the survival outcomes of patients with RRMM. Bispecific antibodies are antibodies that are engineered to simultaneously engage cytotoxic immune effector cells (T cells or NK cells) and malignant plasma cells via binding to immune effector cell antigens and extracellular plasma cell antigens leading to immune effector cell activation and malignant plasma cell destruction. Currently, bispecific antibodies that bind CD3 on T cells and plasma cell epitopes such as B-cell maturation antigen (BCMA), G-protein coupled receptor family C group 5 member D (GPRC5d), and Fc receptor homologue 5 (FcRH5) are the most advanced in clinical development and are showing unprecedented response rates in patients with RRMM, including patients with penta-refractory disease. In this review article, we explore the available clinical data of bispecific antibodies in RRMM and summarize the efficacy, safety, toxicity, clinical outcomes, mechanisms of resistance, and future directions of these therapies in patients with RRMM.
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Affiliation(s)
- Ricardo D. Parrondo
- Division of Hematology-Oncology and Blood and Marrow Transplantation Program, and Cellular Therapies, Mayo Clinic Comprehensive Cancer Center, Jacksonville, FL, United States
| | - Sikander Ailawadhi
- Division of Hematology-Oncology and Blood and Marrow Transplantation Program, and Cellular Therapies, Mayo Clinic Comprehensive Cancer Center, Jacksonville, FL, United States
| | - Claudio Cerchione
- Hematology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
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7
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Zhou X, Xiao X, Kortuem KM, Einsele H. Bispecific Antibodies in the Treatment of Multiple Myeloma. Hematol Oncol Clin North Am 2024; 38:361-381. [PMID: 38199897 DOI: 10.1016/j.hoc.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
The treatment of multiple myeloma (MM) is evolving rapidly. In recent years, T-cell-based novel immunotherapies emerged as new treatment strategies for patients with relapsed/refractory MM, including highly effective new options like chimeric antigen receptor (CAR)-modified T cells and bispecific antibodies (bsAbs). Currently, B-cell maturation antigen is the most commonly used target antigen for CAR T-cell and bsAb therapies in MM. Results from different clinical trials have demonstrated promising efficacy and acceptable safety profile of bsAb in RRMM.
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Affiliation(s)
- Xiang Zhou
- Department of Internal Medicine II, University Hospital of Würzburg, Würzburg, Germany
| | - Xianghui Xiao
- Department of Internal Medicine II, University Hospital of Würzburg, Würzburg, Germany
| | - Klaus Martin Kortuem
- Department of Internal Medicine II, University Hospital of Würzburg, Würzburg, Germany
| | - Hermann Einsele
- Department of Internal Medicine II, University Hospital of Würzburg, Würzburg, Germany.
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Tomita U, Ishimoto Y, Ri M, Kawase Y, Hizukuri Y, Maru C, Nanai K, Nakamura R, Nakayama M, Oguchi-Oshima K, Sumi H, Ohtsuka T, Iida S, Agatsuma T. A novel T cell-redirecting anti-GPRC5D × CD3 bispecific antibody with potent antitumor activity in multiple myeloma preclinical models. Sci Rep 2024; 14:5135. [PMID: 38429446 PMCID: PMC10907593 DOI: 10.1038/s41598-024-55143-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 02/20/2024] [Indexed: 03/03/2024] Open
Abstract
G-protein-coupled receptor class 5 member D (GPRC5D) is detected in malignant plasma cells in approximately 90% of patients diagnosed with multiple myeloma (MM). Here, we constructed BsAb5003, a novel humanized bispecific monoclonal antibody targeting CD3 and GPRC5D, and evaluated its therapeutic impact on MM. BsAb5003 induced specific cytotoxicity of GPRC5D-positive MM cells with concomitant T cell activation and cytokine release. The efficacy of BsAb5003 was associated with GPRC5D expression levels in MM cell lines. Flow cytometry analysis of bone marrow mononuclear cells (BMMNCs) from 49 MM patients revealed that GPRC5D was expressed in a wide population of MM patients, including heavily treated and high-risk patients. In ex vivo assays using BMMNCs, BsAb5003 induced potent efficacy against CD138 + MM cells in both newly diagnosed and relapsed/refractory patient samples in a GPRC5D expression-dependent manner. BsAb5003 significantly enhanced T cell activation and cytokine production in combination with immunomodulatory drugs (IMiDs) against MM cell lines. BsAb5003 also demonstrated significant inhibition of in vivo tumor growth by recruiting T cells. Taken together, these results suggest that T cell-redirecting bispecific antibody targeting GPRC5D as monotherapy and combination therapy with IMiDs could be a highly potent and effective treatment approach for a wide population of MM patients.
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Affiliation(s)
| | | | - Masaki Ri
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | | | | | | | | | | | | | | | | | | | - Shinsuke Iida
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
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Liu L, Krishnan A. Talquetamab in multiple myeloma. Haematologica 2024; 109:718-724. [PMID: 37855056 PMCID: PMC10905093 DOI: 10.3324/haematol.2023.283931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 10/10/2023] [Indexed: 10/20/2023] Open
Abstract
Initial results of the phase I trial of talquetamab, a bispecific antibody targeting GPRC5D and CD3, were reported in December of 2022 for the treatment of relapsed or refractory multiple myeloma in the fourth line or later setting. It demonstrated a similar efficacy profile and durability of response to teclistamab, the first bispecific antibody therapy to be approved in multiple myeloma. Additionally, it has less infections than teclistamab but demonstrates unique class-specific side effects including skin, oral, and nail-related adverse events. Despite this, it is still a highly efficacious and well-tolerated therapy that will add to the armamentarium of therapeutics against heavily pretreated multiple myeloma.
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Affiliation(s)
- Lawrence Liu
- Judy and Bernard Briskin Center for Multiple Myeloma Research, Department of Hematology and Hematopoietic Cell Transplantation, City of Hope Comprehensive Cancer Center, Duarte, CA.
| | - Amrita Krishnan
- Judy and Bernard Briskin Center for Multiple Myeloma Research, Department of Hematology and Hematopoietic Cell Transplantation, City of Hope Comprehensive Cancer Center, Duarte, CA
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Scharf MM, Humphrys LJ, Berndt S, Di Pizio A, Lehmann J, Liebscher I, Nicoli A, Niv MY, Peri L, Schihada H, Schulte G. The dark sides of the GPCR tree - research progress on understudied GPCRs. Br J Pharmacol 2024. [PMID: 38339984 DOI: 10.1111/bph.16325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 11/24/2023] [Accepted: 01/08/2024] [Indexed: 02/12/2024] Open
Abstract
A large portion of the human GPCRome is still in the dark and understudied, consisting even of entire subfamilies of GPCRs such as odorant receptors, class A and C orphans, adhesion GPCRs, Frizzleds and taste receptors. However, it is undeniable that these GPCRs bring an untapped therapeutic potential that should be explored further. Open questions on these GPCRs span diverse topics such as deorphanisation, the development of tool compounds and tools for studying these GPCRs, as well as understanding basic signalling mechanisms. This review gives an overview of the current state of knowledge for each of the diverse subfamilies of understudied receptors regarding their physiological relevance, molecular mechanisms, endogenous ligands and pharmacological tools. Furthermore, it identifies some of the largest knowledge gaps that should be addressed in the foreseeable future and lists some general strategies that might be helpful in this process.
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Affiliation(s)
- Magdalena M Scharf
- Karolinska Institutet, Dept. Physiology & Pharmacology, Sec. Receptor Biology & Signaling, Stockholm, Sweden
| | - Laura J Humphrys
- Institute of Pharmacy, University of Regensburg, Regensburg, Germany
| | - Sandra Berndt
- Rudolf Schönheimer Institute for Biochemistry, Molecular Biochemistry, University of Leipzig, Leipzig, Germany
| | - Antonella Di Pizio
- Leibniz Institute for Food Systems Biology at the Technical University of Munich, Freising, Germany
- Chemoinformatics and Protein Modelling, Department of Molecular Life Science, School of Life Science, Technical University of Munich, Freising, Germany
| | - Juliane Lehmann
- Rudolf Schönheimer Institute for Biochemistry, Molecular Biochemistry, University of Leipzig, Leipzig, Germany
| | - Ines Liebscher
- Rudolf Schönheimer Institute for Biochemistry, Molecular Biochemistry, University of Leipzig, Leipzig, Germany
| | - Alessandro Nicoli
- Leibniz Institute for Food Systems Biology at the Technical University of Munich, Freising, Germany
- Chemoinformatics and Protein Modelling, Department of Molecular Life Science, School of Life Science, Technical University of Munich, Freising, Germany
| | - Masha Y Niv
- The Institute of Biochemistry, Food Science and Nutrition, Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Lior Peri
- The Institute of Biochemistry, Food Science and Nutrition, Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Hannes Schihada
- Institute of Pharmaceutical Chemistry, Philipps-University Marburg, Marburg, Germany
| | - Gunnar Schulte
- Karolinska Institutet, Dept. Physiology & Pharmacology, Sec. Receptor Biology & Signaling, Stockholm, Sweden
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11
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Rodriguez-Otero P, van de Donk NWCJ, Pillarisetti K, Cornax I, Vishwamitra D, Gray K, Hilder B, Tolbert J, Renaud T, Masterson T, Heuck C, Kane C, Verona R, Moreau P, Bahlis N, Chari A. GPRC5D as a novel target for the treatment of multiple myeloma: a narrative review. Blood Cancer J 2024; 14:24. [PMID: 38307865 PMCID: PMC10837198 DOI: 10.1038/s41408-023-00966-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 11/29/2023] [Accepted: 12/05/2023] [Indexed: 02/04/2024] Open
Abstract
Multiple myeloma is a genetically complex and heterogenous malignancy with a 5-year survival rate of approximately 60%. Despite advances in therapy, patients experience cycles of remission and relapse, with each successive line of therapy associated with poorer outcomes; therefore, therapies with different mechanisms of action against new myeloma antigens are needed. G protein-coupled receptor class C group 5 member D (GPRC5D) has emerged as a novel therapeutic target for the treatment of multiple myeloma. We review the biology and target validation of GPRC5D, and clinical data from early phase trials of GPRC5D-targeting bispecific antibodies, talquetamab and forimtamig, and chimeric antigen receptor T cell (CAR-T) therapies, MCARH109, OriCAR-017, and BMS-986393. In addition to adverse events (AEs) associated with T-cell-redirection therapies irrespective of target, a consistent pattern of dermatologic and oral AEs has been reported across several trials of GPRC5D-targeting bispecific antibodies, as well as rare cerebellar events with CAR-T therapy. Additional studies are needed to understand the underlying mechanisms involved in the development of skin- and oral-related toxicities. We review the strategies that have been used to manage these GPRC5D-related toxicities. Preliminary efficacy data showed overall response rates for GPRC5D-targeting T-cell-redirecting therapies were ≥64%; most responders achieved a very good partial response or better. Pharmacokinetics/pharmacodynamics showed that these therapies led to cytokine release and T-cell activation. In conclusion, results from early phase trials of GPRC5D-targeting T-cell-redirecting agents have shown promising efficacy and manageable safety profiles, including lower infection rates compared with B-cell maturation antigen- and Fc receptor-like protein 5-targeting bispecific antibodies. Further clinical trials, including those investigating GPRC5D-targeting T-cell-redirecting agents in combination with other anti-myeloma therapies and with different treatment modalities, may help to elucidate the future optimal treatment regimen and sequence for patients with multiple myeloma and improve survival outcomes. Video Summary.
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Affiliation(s)
| | - Niels W C J van de Donk
- Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | | | | | | | - Brandi Hilder
- Janssen Research & Development, Spring House, PA, USA
| | | | | | | | | | - Colleen Kane
- Janssen Research & Development, Spring House, PA, USA
| | - Raluca Verona
- Janssen Research & Development, Spring House, PA, USA
| | | | - Nizar Bahlis
- Arnie Charbonneau Cancer Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Ajai Chari
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
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12
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Lery M, Perrot A, Ortiz-Brugués A, Vigarios E, Anghel D, Bories P, Sibaud V. Dermatological toxicities induced by T-cell-redirecting G protein-coupled receptor family C class 5 member D bispecific antibody talquetamab. J Am Acad Dermatol 2024; 90:376-377. [PMID: 37742842 DOI: 10.1016/j.jaad.2023.08.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 08/04/2023] [Accepted: 08/27/2023] [Indexed: 09/26/2023]
Affiliation(s)
- Marion Lery
- Department of Onco-Dermatology, Cancer University Institute, Toulouse Oncopole, Toulouse, France
| | - Aurore Perrot
- Department of Haematology, Cancer University Institute, Toulouse Oncopole, Toulouse, France
| | - Ariadna Ortiz-Brugués
- Department of Onco-Dermatology, Cancer University Institute, Toulouse Oncopole, Toulouse, France
| | - Emmanuelle Vigarios
- Department of Oral Medicine, Cancer University Institute, Toulouse Oncopole, Toulouse, France
| | - Diana Anghel
- Department of Onco-Dermatology, Cancer University Institute, Toulouse Oncopole, Toulouse, France
| | - Pierre Bories
- Department of Haematology, Cancer University Institute, Toulouse Oncopole, Toulouse, France
| | - Vincent Sibaud
- Department of Onco-Dermatology, Cancer University Institute, Toulouse Oncopole, Toulouse, France.
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13
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Laheij AMGA, van de Donk NWCJ. Characterization of dysgeusia and xerostomia in patients with multiple myeloma treated with the T-cell redirecting GPRC5D bispecific antibody talquetamab. Support Care Cancer 2023; 32:20. [PMID: 38092979 DOI: 10.1007/s00520-023-08233-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 12/03/2023] [Indexed: 12/18/2023]
Abstract
PURPOSE In recent years, various immunotherapies have improved the survival of patients with multiple myeloma (MM). However, there remains an unmet need for novel agents. Talquetamab is the first-in-class GPRC5D-targeting T-cell redirecting bispecific antibody, which has substantial activity in advanced MM. Rapidly after the start of talquetamab treatment, patients reported taste changes (dysgeusia; 60% of patients), and a feeling of dry mouth (xerostomia; 30-57% of patients), which may be related to expression of the target antigen in healthy tissues, such as taste buds. Here, we aimed at better characterizing these oral toxicities. METHODS We measured salivary flow and the ability to taste (objectively and patient-reported), assessed the feeling of dry mouth, and evaluated quality of life before and 8 weeks after the start of talquetamab therapy in eight heavily pretreated MM patients. RESULTS Talquetamab treatment led to the rapid and significant decrease in objectively measured taste scores (total score 8.8 ± 2.0 vs 4.9 ± 2.5). All patients reported moderate to severe taste changes. Moreover, patients experienced severe xerostomia after the initiation of talquetamab treatment, in the absence of changes in unstimulated and stimulated salivary flow. Because of these oral toxicities a significant impairment in global health status/(oral health related) quality of life was reported. CONCLUSION Studying taste changes in patients treated with talquetamab following up on the described leads provides a new and unique opportunity to further unravel the pathophysiology of taste changes after cancer treatment.
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Affiliation(s)
- A M G A Laheij
- Department of Oral Medicine, Academic Center for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit, Gustav Mahlerlaan 3004, 1008, LA, Amsterdam, the Netherlands.
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
| | - N W C J van de Donk
- Department of Hematology, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, the Netherlands
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14
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Liu Y, Zhou YQ, Nie L, Zhu SS, Li N, Wu ZH, Wang Q, Qi J, Wu BY, Chen SQ, Wang HB. BR109, a Novel Fully Humanized T-Cell-Engaging Bispecific Antibody with GPRC5D Binding, Has Potent Antitumor Activities in Multiple Myeloma. Cancers (Basel) 2023; 15:5774. [PMID: 38136320 PMCID: PMC10741763 DOI: 10.3390/cancers15245774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 12/05/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023] Open
Abstract
At present, multiple myeloma (MM) is still an essentially incurable hematologic malignancy. Although BCMA-targeted therapies have achieved remarkable results, BCMA levels were found to be downregulated in patients with MM who relapsed after these treatments. Therefore, the search for other antigens specific to MM has become a priority. Independently of BCMA expression, G-protein-coupled receptor family C group 5 member D (GPRC5D) is mainly expressed in the plasma cells of MM patients, while it is expressed in a limited number of normal tissues. Combining MM-specific antigen GPRC5D and T-cell-mediated therapies would be a promising therapeutic strategy for MM. Recently, we constructed a new anti-GPRC5D × anti-CD3 T-cell-engaging bispecific antibody (TCB), BR109, which was capable of binding to human GPRC5D and human CD3ε. Moreover, BR109 was proven to have relatively good stability and antitumor activity. BR109 could specifically trigger T-cell-mediated cytotoxicity against many GPRC5D-positive MM cells in vitro. Meanwhile, antitumor activity was demonstrated in MM cell line xenograft mouse models with human immune cell reconstitution. These preclinical studies have formed a solid foundation for the evaluation of MM treatment efficacy in clinical trials.
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Affiliation(s)
- Ying Liu
- College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China;
- Bioray Biopharmaceutical Co., Ltd., Taizhou 318000, China; (Y.-Q.Z.); (L.N.); (S.-S.Z.); (N.L.); (Z.-H.W.); (Q.W.); (J.Q.); (B.-Y.W.)
- Hisun Biopharmaceutical Co., Ltd., Hangzhou 311404, China
| | - Ya-Qiong Zhou
- Bioray Biopharmaceutical Co., Ltd., Taizhou 318000, China; (Y.-Q.Z.); (L.N.); (S.-S.Z.); (N.L.); (Z.-H.W.); (Q.W.); (J.Q.); (B.-Y.W.)
- Hisun Biopharmaceutical Co., Ltd., Hangzhou 311404, China
| | - Lei Nie
- Bioray Biopharmaceutical Co., Ltd., Taizhou 318000, China; (Y.-Q.Z.); (L.N.); (S.-S.Z.); (N.L.); (Z.-H.W.); (Q.W.); (J.Q.); (B.-Y.W.)
- Hisun Biopharmaceutical Co., Ltd., Hangzhou 311404, China
| | - Shan-Shan Zhu
- Bioray Biopharmaceutical Co., Ltd., Taizhou 318000, China; (Y.-Q.Z.); (L.N.); (S.-S.Z.); (N.L.); (Z.-H.W.); (Q.W.); (J.Q.); (B.-Y.W.)
- Hisun Biopharmaceutical Co., Ltd., Hangzhou 311404, China
| | - Na Li
- Bioray Biopharmaceutical Co., Ltd., Taizhou 318000, China; (Y.-Q.Z.); (L.N.); (S.-S.Z.); (N.L.); (Z.-H.W.); (Q.W.); (J.Q.); (B.-Y.W.)
| | - Zhen-Hua Wu
- Bioray Biopharmaceutical Co., Ltd., Taizhou 318000, China; (Y.-Q.Z.); (L.N.); (S.-S.Z.); (N.L.); (Z.-H.W.); (Q.W.); (J.Q.); (B.-Y.W.)
| | - Qi Wang
- Bioray Biopharmaceutical Co., Ltd., Taizhou 318000, China; (Y.-Q.Z.); (L.N.); (S.-S.Z.); (N.L.); (Z.-H.W.); (Q.W.); (J.Q.); (B.-Y.W.)
| | - Jian Qi
- Bioray Biopharmaceutical Co., Ltd., Taizhou 318000, China; (Y.-Q.Z.); (L.N.); (S.-S.Z.); (N.L.); (Z.-H.W.); (Q.W.); (J.Q.); (B.-Y.W.)
- Hisun Biopharmaceutical Co., Ltd., Hangzhou 311404, China
| | - Bing-Yuan Wu
- Bioray Biopharmaceutical Co., Ltd., Taizhou 318000, China; (Y.-Q.Z.); (L.N.); (S.-S.Z.); (N.L.); (Z.-H.W.); (Q.W.); (J.Q.); (B.-Y.W.)
- Hisun Biopharmaceutical Co., Ltd., Hangzhou 311404, China
| | - Shu-Qing Chen
- College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China;
| | - Hai-Bin Wang
- Bioray Biopharmaceutical Co., Ltd., Taizhou 318000, China; (Y.-Q.Z.); (L.N.); (S.-S.Z.); (N.L.); (Z.-H.W.); (Q.W.); (J.Q.); (B.-Y.W.)
- Hisun Biopharmaceutical Co., Ltd., Hangzhou 311404, China
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15
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Sadek NL, Costa BA, Nath K, Mailankody S. CAR T-Cell Therapy for Multiple Myeloma: A Clinical Practice-Oriented Review. Clin Pharmacol Ther 2023; 114:1184-1195. [PMID: 37750399 DOI: 10.1002/cpt.3057] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 09/02/2023] [Indexed: 09/27/2023]
Abstract
The emergence of chimeric antigen receptor (CAR) T-cell therapy has revolutionized the treatment of hematologic malignancies, including multiple myeloma (MM). Two BCMA-directed CAR T-cell products - idecabtagene vicleucel (ide-cel) and ciltacabtagene autoleucel (cilta-cel) - have received US Food and Drug Administration (FDA) approval for patients with relapsed/refractory MM who underwent four or more prior lines of therapy (including an immunomodulatory agent, a proteasome inhibitor, and an anti-CD38 monoclonal antibody). Despite producing unprecedented response rates in an otherwise difficult to treat patient population, CAR T-cell therapies are commonly associated with immune-related adverse events (e.g., cytokine release syndrome and neurotoxicity), cytopenias, and infections. Moreover, many patients continue to exhibit relapse post-treatment, with resistance mechanisms yet to be fully understood. Ongoing basic, translational, and clinical research efforts are poised to generate deeper insights into the optimal utilization of these therapies, improve their efficacy, minimize associated toxicity, and identify new target antigens in patients with MM.
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Affiliation(s)
- Norah Layla Sadek
- Department of Medicine, Mount Sinai Morningside and West, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Bruno Almeida Costa
- Department of Medicine, Mount Sinai Morningside and West, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Karthik Nath
- Department of Medicine, Cellular Therapy Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Sham Mailankody
- Department of Medicine, Cellular Therapy Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of Medicine, Myeloma Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of Medicine, Weill Cornell Medical College, New York, New York, USA
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16
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Del Giudice ML, Galimberti S, Buda G. Beyond BCMA, why GPRC5D could be the right way: treatment strategies with immunotherapy at relapse after anti-BCMA agents. Cancer Immunol Immunother 2023; 72:3931-3937. [PMID: 37924369 DOI: 10.1007/s00262-023-03559-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/06/2023] [Indexed: 11/06/2023]
Abstract
Multiple Myeloma remains incurable, and there is a need for therapies with novel mechanisms of action. Recently, B cell maturation antigen targeted therapy has demonstrated deep and durable responses in a largely treated population. However, the relapse rate of myeloma patients after anti-BCMA treatment strategies is increasing worldwide, and one of the most challenging issues for them is to choose the best therapy sequencing. After anti-BCMA treatment, retreatment with anti-BCMA drugs remains an option, but new targets are emerging strongly. One of them is G protein-coupled receptor, class C group 5 member D (GPRC5D), that due to the very promising data from the use of chimeric antigen receptor T-cells (CAR-T) and bispecific antibodies (BsAb) seems to be the ideal candidate in the relay of myeloma treatment at relapse. In this literature review, we discuss data from treatment with the new drugs at relapse after anti-BCMA therapies, observing an undeniable benefit from the use of drugs directed against GPRC5D.
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Affiliation(s)
- Maria Livia Del Giudice
- Department of Clinical and Experimental Medicine, Hematology, University of Pisa, 56126, Pisa, Italy.
| | - Sara Galimberti
- Department of Clinical and Experimental Medicine, Hematology, University of Pisa, 56126, Pisa, Italy
| | - Gabriele Buda
- Department of Clinical and Experimental Medicine, Hematology, University of Pisa, 56126, Pisa, Italy
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17
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van de Donk NWCJ, O'Neill C, de Ruijter MEM, Verkleij CPM, Zweegman S. T-cell redirecting bispecific and trispecific antibodies in multiple myeloma beyond BCMA. Curr Opin Oncol 2023; 35:601-611. [PMID: 37501530 PMCID: PMC10566598 DOI: 10.1097/cco.0000000000000983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
PURPOSE OF REVIEW B-cell maturation antigen (BCMA)-directed T-cell immunotherapies, such as chimeric antigen receptor T-cells (CAR T-cells) and bispecific antibodies (BsAbs) have markedly improved the survival of triple-class refractory multiple myeloma (MM). However, the majority of patients still develops disease progression, underlining the need for new agents for these patients. RECENT FINDINGS Novel T-cell redirecting BsAbs targeting alternative tumor-associated antigens have shown great promise in heavily pretreated MM, including patients previously exposed to BCMA-directed therapies. This includes the G-protein-coupled receptor class 5 member D (GPRC5D)-targeting BsAbs talquetamab and forimtamig, as well as the Fc receptor-homolog 5 (FcRH5)-targeting BsAb cevostamab. Toxicity associated with these BsAbs includes cytokine-release syndrome, cytopenias, and infections. In addition, GPRC5D-targeting BsAbs are associated with specific 'on target/off tumor' toxicities including rash, nail disorders, and dysgeusia. Trispecifc antibodies targeting two different MM-associated antigens to prevent antigen escape are in early clinical development, as well as trispecific antibodies (TsAbs) that provide an additional co-stimulatory signal to T-cells to prevent their exhaustion. SUMMARY Various T-cell redirecting BsAbs are in advanced stages of clinical development with promising activity and a manageable toxicity profile. Ongoing studies are evaluating combination strategies, fixed-duration treatment, and use of BsAbs in earlier lines of therapy. TsAbs hold great promise for the future.
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Affiliation(s)
- Niels W C J van de Donk
- Department of Hematology, Amsterdam UMC, location Vrije Universiteit Amsterdam
- Cancer Center Amsterdam, Cancer Biology and Immunology, Amsterdam, The Netherlands
| | - Chloe O'Neill
- Department of Hematology, Amsterdam UMC, location Vrije Universiteit Amsterdam
- Cancer Center Amsterdam, Cancer Biology and Immunology, Amsterdam, The Netherlands
| | - Maaike E M de Ruijter
- Department of Hematology, Amsterdam UMC, location Vrije Universiteit Amsterdam
- Cancer Center Amsterdam, Cancer Biology and Immunology, Amsterdam, The Netherlands
| | - Christie P M Verkleij
- Department of Hematology, Amsterdam UMC, location Vrije Universiteit Amsterdam
- Cancer Center Amsterdam, Cancer Biology and Immunology, Amsterdam, The Netherlands
| | - Sonja Zweegman
- Department of Hematology, Amsterdam UMC, location Vrije Universiteit Amsterdam
- Cancer Center Amsterdam, Cancer Biology and Immunology, Amsterdam, The Netherlands
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18
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Holstein SA, Grant SJ, Wildes TM. Chimeric Antigen Receptor T-Cell and Bispecific Antibody Therapy in Multiple Myeloma: Moving Into the Future. J Clin Oncol 2023; 41:4416-4429. [PMID: 37471687 PMCID: PMC10522112 DOI: 10.1200/jco.23.00512] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/18/2023] [Accepted: 06/13/2023] [Indexed: 07/22/2023] Open
Abstract
Historically, the outcomes for individuals with triple-class refractory and penta-drug refractory multiple myeloma (MM) have been poor because of a dearth of effective treatment options. However, the advent of chimeric antigen receptor (CAR) T-cell and T-cell redirecting bispecific antibody (BsAb) therapies has led to unprecedented response rates and durations of response in heavily relapsed/refractory (R/R) populations. Currently, two B-cell maturation antigen (BCMA)-directed CAR T-cell therapies (idecabtagene vicleucel and ciltacabtagene autoleucel) as well as one BCMA/CD3 BsAb (teclistamab) have been approved for late-line (greater than four previous lines) R/R MM in the United States. The purpose of this review is to analyze the recent data for these approved therapies as well as provide an overview of other related CAR T-cell and BsAb therapies under development, including non-BCMA-targeting agents. We review efficacy and safety considerations, with particular focus on cytokine release syndrome, neurotoxicity, and infection risk. The relative merits and limitations of each class of therapy are discussed, as well as the areas of unmet need with respect to optimal sequencing and supportive care measures. We examine the factors that challenge equitable access to these novel therapies across minoritized racial, ethnic, and socioeconomic populations. Although it is evident that CAR T-cell and BsAb therapies will transform treatment paradigms in MM for years to come, significant work remains to identify the optimal utilization of these novel therapies and ensure equitable access.
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Affiliation(s)
- Sarah A. Holstein
- Division of Oncology and Hematology, University of Nebraska Medical Center, Omaha, NE
| | - Shakira J. Grant
- Division of Hematology, The University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Tanya M. Wildes
- Division of Oncology and Hematology, University of Nebraska Medical Center, Omaha, NE
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19
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O'Neill C, van de Donk NWCJ. T-cell redirecting bispecific antibodies in multiple myeloma: Current landscape and future directions. EJHAEM 2023; 4:811-822. [PMID: 37601851 PMCID: PMC10435697 DOI: 10.1002/jha2.729] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 05/19/2023] [Accepted: 05/25/2023] [Indexed: 08/22/2023]
Abstract
T-cell engaging bispecific antibodies (BsAbs) have substantial activity in heavily pretreated patients with multiple myeloma (MM). The overall response rate obtained with B-cell maturation antigen (BCMA)-targeting BsAbs is approximately 60%-70%, including a high proportion of patients achieving very good partial response or complete response. Comparable efficacy is seen with BsAbs targeting GPRC5D or FcRH5. Cytokine release syndrome is frequently observed with BsAb treatment, but mostly during the step-up doses and the first full dose. Early intervention with IL-6 receptor blocking antibodies (e.g., tocilizumab) prevents escalation to severe manifestations. Infections are also common during treatment and related to the extent of exposure to immune suppressive anti-MM agents, as well as development of hypogammaglobulinemia due to elimination of normal plasma cells, and probably because of T-cell exhaustion resulting from continuous BsAb-mediated T-cell activation. Adequate monitoring for infections and institution of infectious prophylaxis are essential. Patients treated with GPRC5D-targteing BsAbs often develop skin and nail disorders and loss of taste, which is likely related to GPRC5D expression in cells that produce hard keratin. Currently ongoing studies are aiming at further improving these results by evaluating BsAbs in combination with other drugs, such as immunomodulatory agents and anti-CD38 antibodies, as well as the application of BsAbs in earlier lines of therapy, including patients with newly diagnosed disease. We expect that the outcomes of patients with MM will further improve by the introduction of this novel type of T-cell immunotherapy.
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Affiliation(s)
- Chloe O'Neill
- Amsterdam UMC, Vrije Universiteit AmsterdamDepartment of HematologyAmsterdamThe Netherlands
- Cancer Center AmsterdamCancer Biology and ImmunologyAmsterdamThe Netherlands
| | - Niels W. C. J. van de Donk
- Amsterdam UMC, Vrije Universiteit AmsterdamDepartment of HematologyAmsterdamThe Netherlands
- Cancer Center AmsterdamCancer Biology and ImmunologyAmsterdamThe Netherlands
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20
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Gambles MT, Yang J, Kopeček J. Multi-targeted immunotherapeutics to treat B cell malignancies. J Control Release 2023; 358:232-258. [PMID: 37121515 PMCID: PMC10330463 DOI: 10.1016/j.jconrel.2023.04.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 04/20/2023] [Accepted: 04/27/2023] [Indexed: 05/02/2023]
Abstract
The concept of multi-targeted immunotherapeutic systems has propelled the field of cancer immunotherapy into an exciting new era. Multi-effector molecules can be designed to engage with, and alter, the patient's immune system in a plethora of ways. The outcomes can vary from effector cell recruitment and activation upon recognition of a cancer cell, to a multipronged immune checkpoint blockade strategy disallowing evasion of the cancer cells by immune cells, or to direct cancer cell death upon engaging multiple cell surface receptors simultaneously. Here, we review the field of multi-specific immunotherapeutics implemented to treat B cell malignancies. The mechanistically diverse strategies are outlined and discussed; common B cell receptor antigen targeting strategies are outlined and summarized; and the challenges of the field are presented along with optimistic insights for the future.
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Affiliation(s)
- M Tommy Gambles
- Center for Controlled Chemical Delivery, University of Utah, Salt Lake City, UT 84112, USA; Department of Molecular Pharmaceutics, University of Utah, Salt Lake City, UT 84112, USA
| | - Jiyuan Yang
- Center for Controlled Chemical Delivery, University of Utah, Salt Lake City, UT 84112, USA; Department of Molecular Pharmaceutics, University of Utah, Salt Lake City, UT 84112, USA.
| | - Jindřich Kopeček
- Center for Controlled Chemical Delivery, University of Utah, Salt Lake City, UT 84112, USA; Department of Molecular Pharmaceutics, University of Utah, Salt Lake City, UT 84112, USA; Department of Biomedical Engineering, University of Utah, Salt Lake City, UT 84112, USA.
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21
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Xia J, Li H, Yan Z, Zhou D, Wang Y, Qi Y, Cao J, Li D, Cheng H, Sang W, Zhu F, Sun H, Chen W, Qi K, Yan D, Qiu T, Qiao J, Yao R, Liu Y, Wang X, Zhang Y, Peng S, Huang CH, Zheng J, Li Z, Chang AH, Xu K. Anti-G Protein-Coupled Receptor, Class C Group 5 Member D Chimeric Antigen Receptor T Cells in Patients With Relapsed or Refractory Multiple Myeloma: A Single-Arm, Phase Ⅱ Trial. J Clin Oncol 2023; 41:2583-2593. [PMID: 36881785 PMCID: PMC10414745 DOI: 10.1200/jco.22.01824] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 01/06/2023] [Accepted: 01/13/2023] [Indexed: 03/09/2023] Open
Abstract
PURPOSE G protein-coupled receptor, class C group 5 member D (GPRC5D) is considered to be a promising surface target for multiple myeloma (MM) immunotherapy. Here, we report the efficacy and safety of anti-GPRC5D chimeric antigen receptor (CAR) T cells in patients with relapsed or refractory (R/R) MM. METHODS This phase Ⅱ, single-arm study enrolled patients (18-70 years) with R/R MM. Lymphodepletion was performed before patients received 2 × 106/kg anti-GPRC5D CAR T cells. The primary end point was the proportion of patients who achieved an overall response. Safety was also evaluated in eligible patients. RESULTS From September 1, 2021, to March 23, 2022, 33 patients were infused with anti-GPRC5D CAR T cells. At a median follow-up of 5.2 months (range, 3.2-8.9), the overall response rate was 91% (95% CI, 76 to 98; 30 of 33 patients), including 11 (33%) stringent complete responses, 10 (30%) complete responses, four (12%) very good partial responses, and five (15%) partial responses. Partial responses or better were observed in nine (100%) of nine patients with previous anti-B-cell maturation antigen (BCMA) CAR T-cell therapy, including two patients who had received repeated anti-BCMA CAR T-cell infusions with no responses at the last time. Grade 3 or higher hematologic toxicities were neutropenia (33 [100%]), anemia (17 [52%]), and thrombocytopenia (15 [45%]). Cytokine release syndrome occurred in 25 (76%) of 33 patients (all were grade 1 or 2), and neurotoxicities in three patients (one grade 2 and one grade 3 ICANSs and one grade 3 headache). CONCLUSION Anti-GPRC5D CAR T-cell therapy showed an encouraging clinical efficacy and manageable safety profile in patients with R/R MM. For patients with MM that progressed after anti-BCMA CAR T-cell therapy or that is refractory to anti-BCMA CAR T cell, anti-GPRC5D CAR T-cell therapy might be a potential alternative option.
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Affiliation(s)
- Jieyun Xia
- Blood Diseases Institute, Xuzhou Medical University, Xuzhou, China
- Department of Hematology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Jiangsu Key Laboratory of Bone Marrow Stem Cells, Xuzhou, China
| | - Hujun Li
- Blood Diseases Institute, Xuzhou Medical University, Xuzhou, China
- Department of Hematology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Jiangsu Key Laboratory of Bone Marrow Stem Cells, Xuzhou, China
| | - Zhiling Yan
- Blood Diseases Institute, Xuzhou Medical University, Xuzhou, China
- Department of Hematology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Jiangsu Key Laboratory of Bone Marrow Stem Cells, Xuzhou, China
| | - Dian Zhou
- Blood Diseases Institute, Xuzhou Medical University, Xuzhou, China
- Department of Hematology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Jiangsu Key Laboratory of Bone Marrow Stem Cells, Xuzhou, China
| | - Ying Wang
- Blood Diseases Institute, Xuzhou Medical University, Xuzhou, China
- Department of Hematology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Jiangsu Key Laboratory of Bone Marrow Stem Cells, Xuzhou, China
| | - Yuekun Qi
- Blood Diseases Institute, Xuzhou Medical University, Xuzhou, China
- Department of Hematology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Jiangsu Key Laboratory of Bone Marrow Stem Cells, Xuzhou, China
| | - Jiang Cao
- Blood Diseases Institute, Xuzhou Medical University, Xuzhou, China
- Department of Hematology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Jiangsu Key Laboratory of Bone Marrow Stem Cells, Xuzhou, China
| | - Depeng Li
- Blood Diseases Institute, Xuzhou Medical University, Xuzhou, China
- Department of Hematology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Jiangsu Key Laboratory of Bone Marrow Stem Cells, Xuzhou, China
| | - Hai Cheng
- Blood Diseases Institute, Xuzhou Medical University, Xuzhou, China
- Department of Hematology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Jiangsu Key Laboratory of Bone Marrow Stem Cells, Xuzhou, China
| | - Wei Sang
- Blood Diseases Institute, Xuzhou Medical University, Xuzhou, China
- Department of Hematology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Jiangsu Key Laboratory of Bone Marrow Stem Cells, Xuzhou, China
| | - Feng Zhu
- Blood Diseases Institute, Xuzhou Medical University, Xuzhou, China
- Department of Hematology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Jiangsu Key Laboratory of Bone Marrow Stem Cells, Xuzhou, China
| | - Haiying Sun
- Blood Diseases Institute, Xuzhou Medical University, Xuzhou, China
- Department of Hematology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Jiangsu Key Laboratory of Bone Marrow Stem Cells, Xuzhou, China
| | - Wei Chen
- Blood Diseases Institute, Xuzhou Medical University, Xuzhou, China
- Department of Hematology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Jiangsu Key Laboratory of Bone Marrow Stem Cells, Xuzhou, China
| | - Kunming Qi
- Blood Diseases Institute, Xuzhou Medical University, Xuzhou, China
- Department of Hematology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Jiangsu Key Laboratory of Bone Marrow Stem Cells, Xuzhou, China
| | - Dongmei Yan
- Blood Diseases Institute, Xuzhou Medical University, Xuzhou, China
- Department of Hematology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Jiangsu Key Laboratory of Bone Marrow Stem Cells, Xuzhou, China
| | - Tingting Qiu
- Blood Diseases Institute, Xuzhou Medical University, Xuzhou, China
- Department of Hematology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Jiangsu Key Laboratory of Bone Marrow Stem Cells, Xuzhou, China
| | - Jianlin Qiao
- Blood Diseases Institute, Xuzhou Medical University, Xuzhou, China
- Jiangsu Key Laboratory of Bone Marrow Stem Cells, Xuzhou, China
| | - Ruosi Yao
- Blood Diseases Institute, Xuzhou Medical University, Xuzhou, China
- Jiangsu Key Laboratory of Bone Marrow Stem Cells, Xuzhou, China
| | - Yang Liu
- Blood Diseases Institute, Xuzhou Medical University, Xuzhou, China
- Department of Hematology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Xue Wang
- Blood Diseases Institute, Xuzhou Medical University, Xuzhou, China
- Department of Hematology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Yanlei Zhang
- Shanghai YaKe Biotechnology Ltd, Shanghai, China
| | - Shuixiu Peng
- Shanghai YaKe Biotechnology Ltd, Shanghai, China
| | | | - Junnian Zheng
- Cancer Institute, Xuzhou Medical University, Xuzhou, China
- Center of Clinical Oncology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Zhenyu Li
- Blood Diseases Institute, Xuzhou Medical University, Xuzhou, China
- Department of Hematology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Jiangsu Key Laboratory of Bone Marrow Stem Cells, Xuzhou, China
| | - Alex H. Chang
- Shanghai YaKe Biotechnology Ltd, Shanghai, China
- Clinical Translational Research Center, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Kailin Xu
- Blood Diseases Institute, Xuzhou Medical University, Xuzhou, China
- Department of Hematology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Jiangsu Key Laboratory of Bone Marrow Stem Cells, Xuzhou, China
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GPRC5D CAR T cells (OriCAR-017) in patients with relapsed or refractory multiple myeloma (POLARIS): a first-in-human, single-centre, single-arm, phase 1 trial. Lancet Haematol 2023; 10:e107-e116. [PMID: 36725117 DOI: 10.1016/s2352-3026(22)00372-6] [Citation(s) in RCA: 36] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 11/14/2022] [Accepted: 11/15/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Chimeric antigen receptor (CAR) T-cell therapy targeting B-cell maturation antigen (BCMA) has shown activity in treating relapsed or refractory multiple myeloma; however, relapse is still common, and new targets are needed. We aimed to assess the activity and safety profile of G protein-coupled receptor class C group 5 member D (GPRC5D)-targeted CAR T cells (OriCAR-017) in patients with relapsed or refractory multiple myeloma. METHODS POLARIS was a first-in-human, single-centre, single-arm, phase 1 trial of GPRC5D-targeted CAR T cells (OriCAR-017) done at the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China. Eligible patients were adults aged 18-75 years with a diagnosis of relapsed or refractory multiple myeloma and an ECOG performance status of 0-2, had GPRC5D expression in bone marrow plasma cells greater than 20% or were positive for GPRC5D by immunohistochemistry, and had received at least three previous lines of treatment including proteasome inhibitors, immunomodulatory drugs, and chemotherapy. Patients were consecutively assigned to receive a single dose of intravenous OriCAR-017 at 1 × 106 CAR T cells per kg, 3 × 106 CAR T cells per kg, or 6 × 106 CAR T cells per kg in the dose-escalation phase. In the expansion phase, patients received the recommended phase 2 dose. Recruitment to the expansion phase terminated early due to the COVID-19 pandemic on May 1, 2022. The primary endpoints were safety, the maximum tolerated dose and the recommended phase 2 dose. Safety and activity analyses included all patients who received OriCAR-017. This trial is registered with ClinicalTrials.gov, NCT05016778. This trial has been completed and is entering long-term follow-up. FINDINGS Between June 9, 2021, and Feb 28, 2022, we recruited 13 patients for inclusion into the study. One patient was excluded because of GPRC5D negativity and two patients discontinued after apheresis because of rapid progression. Nine patients were assigned to the dose escalation phase (three received 1 × 106 CAR T cells per kg, three received 3 × 106 CAR T cells per kg, and three received 6 × 106 CAR T cells per kg). The maximum tolerated dose was not identified, because no dose-limiting toxic effects were observed. On the basis of safety and preliminary activity, the recommended phase 2 dose was set at 3 × 106 CAR T cells per kg, which was received by one additional patient in the dose expansion phase. Five patients (50%) were female, five (50%) were male, and all were Chinese. Five patients (50%) were previously treated with BCMA-targeted CAR T-cell therapy. Median follow-up was 238 days (IQR 182-307). There were no serious adverse events and no treatment-related deaths. The most common grade 3 or worse adverse events were haematological, including neutropenia (ten [100%] of ten patients), thrombocytopenia (nine [90%]), leukopenia (nine [90%]), and anaemia (seven [70%]). All patients had cytokine release syndrome (nine [90%] grade 1 and one [10%] grade 2). No neurological toxic effects were reported. Ten (100%) of ten patients had an overall response, of whom six (60%) had a stringent complete response and four (40%) had very good partial response. Two patients discontinued due to disease progression (one GPRC5D-positive patient in the middle-dose group and one GPRC5D-negative patient in the low-dose group). INTERPRETATION The results of this study suggest that GPRC5D is an active target for immunotherapy in multiple myeloma. GPRC5D-targeted CAR T-cell therapy is a promising treatment modality for patients with relapsed or refractory multiple myeloma and deserves further testing. FUNDING OriCell Therapeutics.
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Chari A, Minnema MC, Berdeja JG, Oriol A, van de Donk NWCJ, Rodríguez-Otero P, Askari E, Mateos MV, Costa LJ, Caers J, Verona R, Girgis S, Yang S, Goldsmith RB, Yao X, Pillarisetti K, Hilder BW, Russell J, Goldberg JD, Krishnan A. Talquetamab, a T-Cell-Redirecting GPRC5D Bispecific Antibody for Multiple Myeloma. N Engl J Med 2022; 387:2232-2244. [PMID: 36507686 DOI: 10.1056/nejmoa2204591] [Citation(s) in RCA: 144] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND G protein-coupled receptor, family C, group 5, member D (GPRC5D) is an orphan receptor expressed in malignant plasma cells. Talquetamab, a bispecific antibody against CD3 and GPRC5D, redirects T cells to mediate killing of GPRC5D-expressing myeloma cells. METHODS In a phase 1 study, we evaluated talquetamab administered intravenously weekly or every other week (in doses from 0.5 to 180 μg per kilogram of body weight) or subcutaneously weekly, every other week, or monthly (5 to 1600 μg per kilogram) in patients who had heavily pretreated relapsed or refractory multiple myeloma that had progressed with established therapies (a median of six previous lines of therapy) or who could not receive these therapies without unacceptable side effects. The primary end points - the frequency and type of dose-limiting toxic effects (study part 1 only), adverse events, and laboratory abnormalities - were assessed in order to select the recommended doses for a phase 2 study. RESULTS At the data-cutoff date, 232 patients had received talquetamab (102 intravenously and 130 subcutaneously). At the two subcutaneous doses recommended for a phase 2 study (405 μg per kilogram weekly [30 patients] and 800 μg per kilogram every other week [44 patients]), common adverse events were cytokine release syndrome (in 77% and 80% of the patients, respectively), skin-related events (in 67% and 70%), and dysgeusia (in 63% and 57%); all but one cytokine release syndrome event were of grade 1 or 2. One dose-limiting toxic effect of grade 3 rash was reported in a patient who had received talquetamab at the 800-μg dose level. At median follow-ups of 11.7 months (in patients who had received talquetamab at the 405-μg dose level) and 4.2 months (in those who had received it at the 800-μg dose level), the percentages of patients with a response were 70% (95% confidence interval [CI], 51 to 85) and 64% (95% CI, 48 to 78), respectively. The median duration of response was 10.2 months and 7.8 months, respectively. CONCLUSIONS Cytokine release syndrome, skin-related events, and dysgeusia were common with talquetamab treatment but were primarily low-grade. Talquetamab induced a substantial response among patients with heavily pretreated relapsed or refractory multiple myeloma. (Funded by Janssen Research and Development; MonumenTAL-1 ClinicalTrials.gov number, NCT03399799.).
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Affiliation(s)
- Ajai Chari
- From the Mount Sinai School of Medicine, New York (A.C.); University Medical Center Utrecht, Utrecht University, Utrecht (M.C.M.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.G.B.); Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona, Barcelona (A.O.), Clínica Universidad de Navarra, Pamplona (P.R.-O.), Hospital Universitario Fundación Jiménez Díaz, Madrid (E.A.), and University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro de Investigación del Cáncer, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (M.-V.M.) - all in Spain; the University of Alabama at Birmingham, Birmingham (L.J.C.); Centre Hospitalier Universitaire de Liège, Liege, Belgium (J.C.); Janssen Research and Development, Spring House, PA (R.V., S.G., S.Y., R.B.G., K.P., B.W.H., J.R.); Janssen Research and Development, La Jolla (X.Y.), and City of Hope Comprehensive Cancer Center, Duarte (A.K.) - both in California; and Janssen Research and Development, Raritan, NJ (J.D.G.)
| | - Monique C Minnema
- From the Mount Sinai School of Medicine, New York (A.C.); University Medical Center Utrecht, Utrecht University, Utrecht (M.C.M.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.G.B.); Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona, Barcelona (A.O.), Clínica Universidad de Navarra, Pamplona (P.R.-O.), Hospital Universitario Fundación Jiménez Díaz, Madrid (E.A.), and University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro de Investigación del Cáncer, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (M.-V.M.) - all in Spain; the University of Alabama at Birmingham, Birmingham (L.J.C.); Centre Hospitalier Universitaire de Liège, Liege, Belgium (J.C.); Janssen Research and Development, Spring House, PA (R.V., S.G., S.Y., R.B.G., K.P., B.W.H., J.R.); Janssen Research and Development, La Jolla (X.Y.), and City of Hope Comprehensive Cancer Center, Duarte (A.K.) - both in California; and Janssen Research and Development, Raritan, NJ (J.D.G.)
| | - Jesus G Berdeja
- From the Mount Sinai School of Medicine, New York (A.C.); University Medical Center Utrecht, Utrecht University, Utrecht (M.C.M.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.G.B.); Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona, Barcelona (A.O.), Clínica Universidad de Navarra, Pamplona (P.R.-O.), Hospital Universitario Fundación Jiménez Díaz, Madrid (E.A.), and University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro de Investigación del Cáncer, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (M.-V.M.) - all in Spain; the University of Alabama at Birmingham, Birmingham (L.J.C.); Centre Hospitalier Universitaire de Liège, Liege, Belgium (J.C.); Janssen Research and Development, Spring House, PA (R.V., S.G., S.Y., R.B.G., K.P., B.W.H., J.R.); Janssen Research and Development, La Jolla (X.Y.), and City of Hope Comprehensive Cancer Center, Duarte (A.K.) - both in California; and Janssen Research and Development, Raritan, NJ (J.D.G.)
| | - Albert Oriol
- From the Mount Sinai School of Medicine, New York (A.C.); University Medical Center Utrecht, Utrecht University, Utrecht (M.C.M.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.G.B.); Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona, Barcelona (A.O.), Clínica Universidad de Navarra, Pamplona (P.R.-O.), Hospital Universitario Fundación Jiménez Díaz, Madrid (E.A.), and University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro de Investigación del Cáncer, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (M.-V.M.) - all in Spain; the University of Alabama at Birmingham, Birmingham (L.J.C.); Centre Hospitalier Universitaire de Liège, Liege, Belgium (J.C.); Janssen Research and Development, Spring House, PA (R.V., S.G., S.Y., R.B.G., K.P., B.W.H., J.R.); Janssen Research and Development, La Jolla (X.Y.), and City of Hope Comprehensive Cancer Center, Duarte (A.K.) - both in California; and Janssen Research and Development, Raritan, NJ (J.D.G.)
| | - Niels W C J van de Donk
- From the Mount Sinai School of Medicine, New York (A.C.); University Medical Center Utrecht, Utrecht University, Utrecht (M.C.M.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.G.B.); Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona, Barcelona (A.O.), Clínica Universidad de Navarra, Pamplona (P.R.-O.), Hospital Universitario Fundación Jiménez Díaz, Madrid (E.A.), and University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro de Investigación del Cáncer, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (M.-V.M.) - all in Spain; the University of Alabama at Birmingham, Birmingham (L.J.C.); Centre Hospitalier Universitaire de Liège, Liege, Belgium (J.C.); Janssen Research and Development, Spring House, PA (R.V., S.G., S.Y., R.B.G., K.P., B.W.H., J.R.); Janssen Research and Development, La Jolla (X.Y.), and City of Hope Comprehensive Cancer Center, Duarte (A.K.) - both in California; and Janssen Research and Development, Raritan, NJ (J.D.G.)
| | - Paula Rodríguez-Otero
- From the Mount Sinai School of Medicine, New York (A.C.); University Medical Center Utrecht, Utrecht University, Utrecht (M.C.M.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.G.B.); Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona, Barcelona (A.O.), Clínica Universidad de Navarra, Pamplona (P.R.-O.), Hospital Universitario Fundación Jiménez Díaz, Madrid (E.A.), and University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro de Investigación del Cáncer, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (M.-V.M.) - all in Spain; the University of Alabama at Birmingham, Birmingham (L.J.C.); Centre Hospitalier Universitaire de Liège, Liege, Belgium (J.C.); Janssen Research and Development, Spring House, PA (R.V., S.G., S.Y., R.B.G., K.P., B.W.H., J.R.); Janssen Research and Development, La Jolla (X.Y.), and City of Hope Comprehensive Cancer Center, Duarte (A.K.) - both in California; and Janssen Research and Development, Raritan, NJ (J.D.G.)
| | - Elham Askari
- From the Mount Sinai School of Medicine, New York (A.C.); University Medical Center Utrecht, Utrecht University, Utrecht (M.C.M.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.G.B.); Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona, Barcelona (A.O.), Clínica Universidad de Navarra, Pamplona (P.R.-O.), Hospital Universitario Fundación Jiménez Díaz, Madrid (E.A.), and University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro de Investigación del Cáncer, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (M.-V.M.) - all in Spain; the University of Alabama at Birmingham, Birmingham (L.J.C.); Centre Hospitalier Universitaire de Liège, Liege, Belgium (J.C.); Janssen Research and Development, Spring House, PA (R.V., S.G., S.Y., R.B.G., K.P., B.W.H., J.R.); Janssen Research and Development, La Jolla (X.Y.), and City of Hope Comprehensive Cancer Center, Duarte (A.K.) - both in California; and Janssen Research and Development, Raritan, NJ (J.D.G.)
| | - María-Victoria Mateos
- From the Mount Sinai School of Medicine, New York (A.C.); University Medical Center Utrecht, Utrecht University, Utrecht (M.C.M.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.G.B.); Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona, Barcelona (A.O.), Clínica Universidad de Navarra, Pamplona (P.R.-O.), Hospital Universitario Fundación Jiménez Díaz, Madrid (E.A.), and University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro de Investigación del Cáncer, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (M.-V.M.) - all in Spain; the University of Alabama at Birmingham, Birmingham (L.J.C.); Centre Hospitalier Universitaire de Liège, Liege, Belgium (J.C.); Janssen Research and Development, Spring House, PA (R.V., S.G., S.Y., R.B.G., K.P., B.W.H., J.R.); Janssen Research and Development, La Jolla (X.Y.), and City of Hope Comprehensive Cancer Center, Duarte (A.K.) - both in California; and Janssen Research and Development, Raritan, NJ (J.D.G.)
| | - Luciano J Costa
- From the Mount Sinai School of Medicine, New York (A.C.); University Medical Center Utrecht, Utrecht University, Utrecht (M.C.M.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.G.B.); Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona, Barcelona (A.O.), Clínica Universidad de Navarra, Pamplona (P.R.-O.), Hospital Universitario Fundación Jiménez Díaz, Madrid (E.A.), and University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro de Investigación del Cáncer, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (M.-V.M.) - all in Spain; the University of Alabama at Birmingham, Birmingham (L.J.C.); Centre Hospitalier Universitaire de Liège, Liege, Belgium (J.C.); Janssen Research and Development, Spring House, PA (R.V., S.G., S.Y., R.B.G., K.P., B.W.H., J.R.); Janssen Research and Development, La Jolla (X.Y.), and City of Hope Comprehensive Cancer Center, Duarte (A.K.) - both in California; and Janssen Research and Development, Raritan, NJ (J.D.G.)
| | - Jo Caers
- From the Mount Sinai School of Medicine, New York (A.C.); University Medical Center Utrecht, Utrecht University, Utrecht (M.C.M.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.G.B.); Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona, Barcelona (A.O.), Clínica Universidad de Navarra, Pamplona (P.R.-O.), Hospital Universitario Fundación Jiménez Díaz, Madrid (E.A.), and University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro de Investigación del Cáncer, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (M.-V.M.) - all in Spain; the University of Alabama at Birmingham, Birmingham (L.J.C.); Centre Hospitalier Universitaire de Liège, Liege, Belgium (J.C.); Janssen Research and Development, Spring House, PA (R.V., S.G., S.Y., R.B.G., K.P., B.W.H., J.R.); Janssen Research and Development, La Jolla (X.Y.), and City of Hope Comprehensive Cancer Center, Duarte (A.K.) - both in California; and Janssen Research and Development, Raritan, NJ (J.D.G.)
| | - Raluca Verona
- From the Mount Sinai School of Medicine, New York (A.C.); University Medical Center Utrecht, Utrecht University, Utrecht (M.C.M.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.G.B.); Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona, Barcelona (A.O.), Clínica Universidad de Navarra, Pamplona (P.R.-O.), Hospital Universitario Fundación Jiménez Díaz, Madrid (E.A.), and University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro de Investigación del Cáncer, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (M.-V.M.) - all in Spain; the University of Alabama at Birmingham, Birmingham (L.J.C.); Centre Hospitalier Universitaire de Liège, Liege, Belgium (J.C.); Janssen Research and Development, Spring House, PA (R.V., S.G., S.Y., R.B.G., K.P., B.W.H., J.R.); Janssen Research and Development, La Jolla (X.Y.), and City of Hope Comprehensive Cancer Center, Duarte (A.K.) - both in California; and Janssen Research and Development, Raritan, NJ (J.D.G.)
| | - Suzette Girgis
- From the Mount Sinai School of Medicine, New York (A.C.); University Medical Center Utrecht, Utrecht University, Utrecht (M.C.M.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.G.B.); Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona, Barcelona (A.O.), Clínica Universidad de Navarra, Pamplona (P.R.-O.), Hospital Universitario Fundación Jiménez Díaz, Madrid (E.A.), and University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro de Investigación del Cáncer, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (M.-V.M.) - all in Spain; the University of Alabama at Birmingham, Birmingham (L.J.C.); Centre Hospitalier Universitaire de Liège, Liege, Belgium (J.C.); Janssen Research and Development, Spring House, PA (R.V., S.G., S.Y., R.B.G., K.P., B.W.H., J.R.); Janssen Research and Development, La Jolla (X.Y.), and City of Hope Comprehensive Cancer Center, Duarte (A.K.) - both in California; and Janssen Research and Development, Raritan, NJ (J.D.G.)
| | - Shiyi Yang
- From the Mount Sinai School of Medicine, New York (A.C.); University Medical Center Utrecht, Utrecht University, Utrecht (M.C.M.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.G.B.); Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona, Barcelona (A.O.), Clínica Universidad de Navarra, Pamplona (P.R.-O.), Hospital Universitario Fundación Jiménez Díaz, Madrid (E.A.), and University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro de Investigación del Cáncer, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (M.-V.M.) - all in Spain; the University of Alabama at Birmingham, Birmingham (L.J.C.); Centre Hospitalier Universitaire de Liège, Liege, Belgium (J.C.); Janssen Research and Development, Spring House, PA (R.V., S.G., S.Y., R.B.G., K.P., B.W.H., J.R.); Janssen Research and Development, La Jolla (X.Y.), and City of Hope Comprehensive Cancer Center, Duarte (A.K.) - both in California; and Janssen Research and Development, Raritan, NJ (J.D.G.)
| | - Rachel B Goldsmith
- From the Mount Sinai School of Medicine, New York (A.C.); University Medical Center Utrecht, Utrecht University, Utrecht (M.C.M.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.G.B.); Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona, Barcelona (A.O.), Clínica Universidad de Navarra, Pamplona (P.R.-O.), Hospital Universitario Fundación Jiménez Díaz, Madrid (E.A.), and University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro de Investigación del Cáncer, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (M.-V.M.) - all in Spain; the University of Alabama at Birmingham, Birmingham (L.J.C.); Centre Hospitalier Universitaire de Liège, Liege, Belgium (J.C.); Janssen Research and Development, Spring House, PA (R.V., S.G., S.Y., R.B.G., K.P., B.W.H., J.R.); Janssen Research and Development, La Jolla (X.Y.), and City of Hope Comprehensive Cancer Center, Duarte (A.K.) - both in California; and Janssen Research and Development, Raritan, NJ (J.D.G.)
| | - Xiang Yao
- From the Mount Sinai School of Medicine, New York (A.C.); University Medical Center Utrecht, Utrecht University, Utrecht (M.C.M.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.G.B.); Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona, Barcelona (A.O.), Clínica Universidad de Navarra, Pamplona (P.R.-O.), Hospital Universitario Fundación Jiménez Díaz, Madrid (E.A.), and University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro de Investigación del Cáncer, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (M.-V.M.) - all in Spain; the University of Alabama at Birmingham, Birmingham (L.J.C.); Centre Hospitalier Universitaire de Liège, Liege, Belgium (J.C.); Janssen Research and Development, Spring House, PA (R.V., S.G., S.Y., R.B.G., K.P., B.W.H., J.R.); Janssen Research and Development, La Jolla (X.Y.), and City of Hope Comprehensive Cancer Center, Duarte (A.K.) - both in California; and Janssen Research and Development, Raritan, NJ (J.D.G.)
| | - Kodandaram Pillarisetti
- From the Mount Sinai School of Medicine, New York (A.C.); University Medical Center Utrecht, Utrecht University, Utrecht (M.C.M.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.G.B.); Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona, Barcelona (A.O.), Clínica Universidad de Navarra, Pamplona (P.R.-O.), Hospital Universitario Fundación Jiménez Díaz, Madrid (E.A.), and University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro de Investigación del Cáncer, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (M.-V.M.) - all in Spain; the University of Alabama at Birmingham, Birmingham (L.J.C.); Centre Hospitalier Universitaire de Liège, Liege, Belgium (J.C.); Janssen Research and Development, Spring House, PA (R.V., S.G., S.Y., R.B.G., K.P., B.W.H., J.R.); Janssen Research and Development, La Jolla (X.Y.), and City of Hope Comprehensive Cancer Center, Duarte (A.K.) - both in California; and Janssen Research and Development, Raritan, NJ (J.D.G.)
| | - Brandi W Hilder
- From the Mount Sinai School of Medicine, New York (A.C.); University Medical Center Utrecht, Utrecht University, Utrecht (M.C.M.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.G.B.); Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona, Barcelona (A.O.), Clínica Universidad de Navarra, Pamplona (P.R.-O.), Hospital Universitario Fundación Jiménez Díaz, Madrid (E.A.), and University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro de Investigación del Cáncer, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (M.-V.M.) - all in Spain; the University of Alabama at Birmingham, Birmingham (L.J.C.); Centre Hospitalier Universitaire de Liège, Liege, Belgium (J.C.); Janssen Research and Development, Spring House, PA (R.V., S.G., S.Y., R.B.G., K.P., B.W.H., J.R.); Janssen Research and Development, La Jolla (X.Y.), and City of Hope Comprehensive Cancer Center, Duarte (A.K.) - both in California; and Janssen Research and Development, Raritan, NJ (J.D.G.)
| | - Jeffery Russell
- From the Mount Sinai School of Medicine, New York (A.C.); University Medical Center Utrecht, Utrecht University, Utrecht (M.C.M.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.G.B.); Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona, Barcelona (A.O.), Clínica Universidad de Navarra, Pamplona (P.R.-O.), Hospital Universitario Fundación Jiménez Díaz, Madrid (E.A.), and University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro de Investigación del Cáncer, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (M.-V.M.) - all in Spain; the University of Alabama at Birmingham, Birmingham (L.J.C.); Centre Hospitalier Universitaire de Liège, Liege, Belgium (J.C.); Janssen Research and Development, Spring House, PA (R.V., S.G., S.Y., R.B.G., K.P., B.W.H., J.R.); Janssen Research and Development, La Jolla (X.Y.), and City of Hope Comprehensive Cancer Center, Duarte (A.K.) - both in California; and Janssen Research and Development, Raritan, NJ (J.D.G.)
| | - Jenna D Goldberg
- From the Mount Sinai School of Medicine, New York (A.C.); University Medical Center Utrecht, Utrecht University, Utrecht (M.C.M.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.G.B.); Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona, Barcelona (A.O.), Clínica Universidad de Navarra, Pamplona (P.R.-O.), Hospital Universitario Fundación Jiménez Díaz, Madrid (E.A.), and University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro de Investigación del Cáncer, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (M.-V.M.) - all in Spain; the University of Alabama at Birmingham, Birmingham (L.J.C.); Centre Hospitalier Universitaire de Liège, Liege, Belgium (J.C.); Janssen Research and Development, Spring House, PA (R.V., S.G., S.Y., R.B.G., K.P., B.W.H., J.R.); Janssen Research and Development, La Jolla (X.Y.), and City of Hope Comprehensive Cancer Center, Duarte (A.K.) - both in California; and Janssen Research and Development, Raritan, NJ (J.D.G.)
| | - Amrita Krishnan
- From the Mount Sinai School of Medicine, New York (A.C.); University Medical Center Utrecht, Utrecht University, Utrecht (M.C.M.), and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam (N.W.C.J.D.) - both in the Netherlands; Sarah Cannon Research Institute and Tennessee Oncology, Nashville (J.G.B.); Institut Català d'Oncologia and Institut Josep Carreras, Hospital Germans Trias i Pujol, Badalona, Barcelona (A.O.), Clínica Universidad de Navarra, Pamplona (P.R.-O.), Hospital Universitario Fundación Jiménez Díaz, Madrid (E.A.), and University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro de Investigación del Cáncer, Centro de Investigación Biomédica en Red de Cáncer, Salamanca (M.-V.M.) - all in Spain; the University of Alabama at Birmingham, Birmingham (L.J.C.); Centre Hospitalier Universitaire de Liège, Liege, Belgium (J.C.); Janssen Research and Development, Spring House, PA (R.V., S.G., S.Y., R.B.G., K.P., B.W.H., J.R.); Janssen Research and Development, La Jolla (X.Y.), and City of Hope Comprehensive Cancer Center, Duarte (A.K.) - both in California; and Janssen Research and Development, Raritan, NJ (J.D.G.)
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Narayan N, Williams B, Lipe B, De Benedetto A. Onychomadesis and palmoplantar keratoderma associated with talquetamab therapy for relapsed and refractory multiple myeloma. JAAD Case Rep 2022; 31:66-68. [PMID: 36505036 PMCID: PMC9731837 DOI: 10.1016/j.jdcr.2022.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Neha Narayan
- University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Benjamin Williams
- Department of Dermatology, University of Rochester Medical Center, Rochester, New York
| | - Brea Lipe
- Department of Hematology and Oncology, University of Rochester Medical Center, Rochester, New York
| | - Anna De Benedetto
- Department of Dermatology, University of Rochester Medical Center, Rochester, New York,Correspondence to: Anna De Benedetto, MD, Department of Dermatology, University of Rochester Medical Center, 40 Celebration Dr, College Town, Rochester, NY 14620.
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Fu W, Franchini L, Orlandi C. Comprehensive Spatial Profile of the Orphan G Protein Coupled Receptor GPRC5B Expression in Mouse Brain. Front Neurosci 2022; 16:891544. [PMID: 35812210 PMCID: PMC9259939 DOI: 10.3389/fnins.2022.891544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 06/07/2022] [Indexed: 11/13/2022] Open
Abstract
Orphan G Protein Coupled Receptors (GPCRs) are GPCRs whose endogenous ligands are unknown or still debated. Due to the lack of pharmacological modulators, the physiological function of orphan GPCRs is understudied. However, relevant physiological roles associated with orphan GPCRs have been revealed by analysis of animal models and genome wide association studies illuminating an untapped potential for drug discovery. G Protein Coupled Receptor class C Group 5 Member B (GPRC5B) is among the most expressed GPCRs in the central nervous system. Thus, the expression profiling of GPRC5B is an essential step toward understanding GPRC5B function in health and disease. In this study, we generated new GPRC5B polyclonal antibodies and investigated the expression levels of GPRC5B across different organs and brain regions. We identified high levels of GPRC5B glycosylation both in transfected cells and in mouse brain. Moreover, in situ hybridization imaging analysis indicated that Gprc5b was expressed at the highest level in olfactory bulb, hippocampus, cerebellum, and pons. To dissect expression within various neuronal populations, we conducted a comprehensive spatial profiling of Gprc5b across excitatory and inhibitory neuronal types in medial prefrontal cortex, motor cortex, hippocampal regions, hypothalamus, and cerebellum. Overall, we discovered that GABAergic neurons displayed higher Gprc5b expression levels than glutamatergic neurons in most of the analyzed regions with the important exception of the hippocampal dentate gyrus. Overall, the expression analysis of GPRC5B in mouse brain will guide functional studies ultimately positioning GPRC5B in pathophysiological mechanisms and drug discovery.
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Marhelava K, Krawczyk M, Firczuk M, Fidyt K. CAR-T Cells Shoot for New Targets: Novel Approaches to Boost Adoptive Cell Therapy for B Cell-Derived Malignancies. Cells 2022; 11:1804. [PMID: 35681499 PMCID: PMC9180412 DOI: 10.3390/cells11111804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 05/27/2022] [Indexed: 12/10/2022] Open
Abstract
Chimeric antigen receptor (CAR)-T cell therapy is undeniably a promising tool in combating various types of hematological malignancies. However, it is not yet optimal and a significant number of patients experience a lack of response or relapse after the treatment. Therapy improvement requires careful analysis of the occurring problems and a deeper understanding of the reasons that stand behind them. In this review, we summarize the recent knowledge about CAR-T products' clinical performance and discuss diversified approaches taken to improve the major shortcomings of this therapy. Especially, we prioritize the challenges faced by CD19 CAR-T cell-based treatment of B cell-derived malignancies and revise the latest insights about mechanisms mediating therapy resistance. Since the loss of CD19 is one of the major obstacles to the success of CAR-T cell therapy, we present antigens that could be alternatively used for the treatment of various types of B cell-derived cancers.
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Affiliation(s)
- Katsiaryna Marhelava
- Department of Immunology, Medical University of Warsaw, 02-097 Warsaw, Poland; (K.M.); (M.K.); (M.F.)
| | - Marta Krawczyk
- Department of Immunology, Medical University of Warsaw, 02-097 Warsaw, Poland; (K.M.); (M.K.); (M.F.)
- Laboratory of Immunology, Mossakowski Medical Research Institute, Polish Academy of Sciences, 02-106 Warsaw, Poland
- Doctoral School of Translational Medicine, Mossakowski Medical Research Institute, Polish Academy of Sciences, 02-106 Warsaw, Poland
| | - Malgorzata Firczuk
- Department of Immunology, Medical University of Warsaw, 02-097 Warsaw, Poland; (K.M.); (M.K.); (M.F.)
- Laboratory of Immunology, Mossakowski Medical Research Institute, Polish Academy of Sciences, 02-106 Warsaw, Poland
| | - Klaudyna Fidyt
- Department of Immunology, Medical University of Warsaw, 02-097 Warsaw, Poland; (K.M.); (M.K.); (M.F.)
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27
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Li YC, He DQ, Ma YH, Ma Q, Ding W, Chen YH, Zhang M, Luo F, Chen LY, Wang JK, Jiang L, Li YK, Tao JZ. Skin transcriptome analysis identifies the key genes underlying fur development in Chinese Tan sheep in the birth and Er-mao periods. Gene 2022; 820:146257. [PMID: 35143949 DOI: 10.1016/j.gene.2022.146257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 10/21/2021] [Accepted: 01/27/2022] [Indexed: 11/18/2022]
Abstract
Hair follicle development in Tan sheep differs significantly between the birth and Er-mao periods, but the underlying molecular mechanism is still unclear. We profiled the skin transcriptomes of Tan sheep in the birth and Er-mao periods via RNA-seq technology. The Tan sheep examined consisted of three sheep in the birth period and three sheep in the Er-mao period. A total of 364 differentially expressed genes (DEGs) in the skin of Tan sheep between the birth period and the Er-mao period were identified, among which 168 were upregulated and 196 were downregulated. Interestingly, the FOS proto-oncogene (FOS) (fold change = 22.67, P value = 2.15*10^-44) was the most significantly differentially expressed gene. Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis found that the FOS gene was significantly enriched in the signaling pathway related to hair follicle development. Immunohistochemical analysis showed that the FOS gene was expressed in the skin of Chinese Tan sheep at the birth and Er-mao periods, with significantly higher expression in the Er-mao period. Our findings suggest that the FOS gene promotes hair follicle development in Tan sheep.
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Affiliation(s)
- Ya Chao Li
- Agricultural College, Ning Xia University, Yin Chuan 750021, China; The Key Laboratory for Farm Animal Genetic Resources and Utilization of Ministry of Agriculture of China, Institute of Animal Science (IAS), Chinese Academy of Agricultural Sciences (CAAS), Beijing 100193, China
| | - Dong Qian He
- Agricultural College, Ning Xia University, Yin Chuan 750021, China
| | - Yue Hui Ma
- The Key Laboratory for Farm Animal Genetic Resources and Utilization of Ministry of Agriculture of China, Institute of Animal Science (IAS), Chinese Academy of Agricultural Sciences (CAAS), Beijing 100193, China
| | - Qin Ma
- Animal Science Institute of Ning Xia Agricultural and Forestry Academy, Yin Chuan 750002, China
| | - Wei Ding
- Animal Science Institute of Ning Xia Agricultural and Forestry Academy, Yin Chuan 750002, China
| | - Yong Hong Chen
- Agricultural College, Ning Xia University, Yin Chuan 750021, China
| | - Meng Zhang
- Agricultural College, Ning Xia University, Yin Chuan 750021, China
| | - Fang Luo
- Agricultural College, Ning Xia University, Yin Chuan 750021, China
| | - Li Yao Chen
- Agricultural College, Ning Xia University, Yin Chuan 750021, China
| | - Jun Kui Wang
- Agricultural College, Ning Xia University, Yin Chuan 750021, China
| | - Lin Jiang
- The Key Laboratory for Farm Animal Genetic Resources and Utilization of Ministry of Agriculture of China, Institute of Animal Science (IAS), Chinese Academy of Agricultural Sciences (CAAS), Beijing 100193, China.
| | - Ying Kang Li
- Animal Science Institute of Ning Xia Agricultural and Forestry Academy, Yin Chuan 750002, China.
| | - Jin Zhong Tao
- Agricultural College, Ning Xia University, Yin Chuan 750021, China.
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T-cell redirecting bispecific antibodies in multiple myeloma: a revolution? Blood 2022; 139:3681-3687. [PMID: 35404996 DOI: 10.1182/blood.2021014611] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 03/01/2022] [Indexed: 11/20/2022] Open
Abstract
Bispecific antibodies are designed to link a surface target molecule on the malignant plasma cells to CD3 on T-cells and thereby redirect activated T-cells to induce tumor cell death. Early-phase clinical trials targeting B-cell maturation antigen, GPRC5D or FcRH5, have demonstrated a favorable safety profile and promising efficacy data in triple-class refractory multiple myeloma. This novel immunotherapeutic modality will likely change the treatment paradigm in the coming years.
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Hosny M, Verkleij CPM, van der Schans J, Frerichs KA, Mutis T, Zweegman S, van de Donk NWCJ. Current State of the Art and Prospects of T Cell-Redirecting Bispecific Antibodies in Multiple Myeloma. J Clin Med 2021; 10:4593. [PMID: 34640611 PMCID: PMC8509238 DOI: 10.3390/jcm10194593] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/29/2021] [Accepted: 10/01/2021] [Indexed: 12/12/2022] Open
Abstract
Multiple myeloma (MM) patients eventually develop multi-drug-resistant disease with poor survival. Hence, the development of novel treatment strategies is of great importance. Recently, different classes of immunotherapeutic agents have shown great promise in heavily pre-treated MM, including T cell-redirecting bispecific antibodies (BsAbs). These BsAbs simultaneously interact with CD3 on effector T cells and a tumor-associated antigen on MM cells, resulting in redirection of T cells to MM cells. This leads to the formation of an immunologic synapse, the release of granzymes/perforins, and subsequent tumor cell lysis. Several ongoing phase 1 studies show substantial activity and a favorable toxicity profile with BCMA-, GPRC5D-, or FcRH5-targeting BsAbs in heavily pre-treated MM patients. Resistance mechanisms against BsAbs include tumor-related features, T cell characteristics, and impact of components of the immunosuppressive tumor microenvironment. Various clinical trials are currently evaluating combination therapy with a BsAb and another agent, such as a CD38-targeting antibody or an immunomodulatory drug (e.g., pomalidomide), to further improve response depth and duration. Additionally, the combination of two BsAbs, simultaneously targeting two different antigens to prevent antigen escape, is being explored in clinical studies. The evaluation of BsAbs in earlier lines of therapy, including newly diagnosed MM, is warranted, based on the efficacy of BsAbs in advanced MM.
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Affiliation(s)
| | | | | | | | | | | | - Niels W. C. J. van de Donk
- Cancer Center Amsterdam, Department of Hematology, Vrije Universiteit Amsterdam, Amsterdam UMC, 1081 HV Amsterdam, The Netherlands; (M.H.); (C.P.M.V.); (J.v.d.S.); (K.A.F.); (T.M.); (S.Z.)
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Chimeric Antigen Receptor T-Cell Therapeutics for Multiple Myeloma: Moving Into the Spotlight. ACTA ACUST UNITED AC 2021; 27:205-212. [PMID: 34549909 DOI: 10.1097/ppo.0000000000000525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Chimeric antigen receptor (CAR) T-cell therapy has quickly emerged as a highly promising treatment for patients with relapsed and refractory multiple myeloma. There are numerous candidates under development, each with their unique characteristics and points of differentiation. The most recent US Food and Drug Administration approval of the first B-cell maturation antigen-targeted CAR-T cell therapy on March 26, 2021, has paved a path forward for the eventual evaluation of more of these investigational agents undergoing clinical trials. Herein, we highlight, from a clinical development perspective, the CAR-T cell therapies farthest along in development with updated data from the American Society of Hematology 2020 annual meeting. We also discuss potential paths of overcoming resistance to these therapies and the future direction for CAR-T cell therapeutics in multiple myeloma.
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The Agony of Choice-Where to Place the Wave of BCMA-Targeted Therapies in the Multiple Myeloma Treatment Puzzle in 2022 and Beyond. Cancers (Basel) 2021; 13:cancers13184701. [PMID: 34572927 PMCID: PMC8471156 DOI: 10.3390/cancers13184701] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/14/2021] [Accepted: 09/14/2021] [Indexed: 12/11/2022] Open
Abstract
Simple Summary There is no doubt that immunotherapeutic approaches will change the current treatment landscape of multiple myeloma in the near future; in particular, a wave of BCMA-targeted therapies is currently entering clinical routine. Although the increasing availability of different therapeutic approaches is highly welcome, it also increases the daily challenges in clinical decision making if they all use the same target. Here, we provide a comprehensive summary of BCMA-targeted approaches in myeloma and aim to share some basic concepts in clinical decision making. Abstract Since the introduction of first-generation proteasome inhibitors and immunomodulatory agents, the multiple myeloma (MM) treatment landscape has undergone a remarkable development. Most recently, immunotherapeutic strategies targeting the B cell maturation antigen (BCMA) entered the clinical stage providing access to highly anticipated novel treatment strategies. At present, numerous different approaches investigate BCMA as an effective multi-modal target. Currently, BCMA-directed antibody–drug conjugates, bispecific and trispecific antibodies, autologous and allogeneic CAR-T cell as well as CAR-NK cell constructs are either approved or in different stages of clinical and preclinical development for the treatment of MM. This armamentarium of treatment choices raises several challenges for clinical decision making, particularly in the absence of head-to-head comparisons. In this review, we provide a comprehensive overview of BCMA-targeting therapeutics, deliver latest updates on clinical trial data, and focus on potential patient selection criteria for different BCMA-targeting immunotherapeutic strategies.
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Lancman G, Sastow DL, Cho HJ, Jagannath S, Madduri D, Parekh SS, Richard S, Richter J, Sanchez L, Chari A. Bispecific Antibodies in Multiple Myeloma: Present and Future. Blood Cancer Discov 2021; 2:423-433. [PMID: 34661161 PMCID: PMC8510808 DOI: 10.1158/2643-3230.bcd-21-0028] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 05/06/2021] [Accepted: 07/07/2021] [Indexed: 11/16/2022] Open
Abstract
Despite many recent advances in therapy, there is still no plateau in overall survival curves in multiple myeloma. Bispecific antibodies are a novel immunotherapeutic approach designed to bind antigens on malignant plasma cells and cytotoxic immune effector cells. Early-phase clinical trials targeting B-cell maturation antigen (BCMA), GPRC5D, and FcRH5 have demonstrated a favorable safety profile, with mainly low-grade cytokine release syndrome, cytopenias, and infections. Although dose escalation is ongoing in several studies, early efficacy data show response rates in the most active dose cohorts between 61% and 83% with many deep responses; however, durability remains to be established. Further clinical trial data are eagerly anticipated. SIGNIFICANCE Overall survival of triple-class refractory multiple myeloma remains poor. Bispecific antibodies are a novel immunotherapeutic modality with a favorable safety profile and impressive preliminary efficacy in heavily treated patients. Although more data are needed, bispecifics will likely become an integral part of the multiple myeloma treatment paradigm in the near future. Studies in earlier lines of therapy and in combination with other active anti-multiple myeloma agents will help further define the role of bispecifics in multiple myeloma.
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Affiliation(s)
- Guido Lancman
- Tisch Cancer Insitute, Icahn School of Medicine at Mount Sinai, New York, New York
| | | | - Hearn J Cho
- Tisch Cancer Insitute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Sundar Jagannath
- Tisch Cancer Insitute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Deepu Madduri
- Tisch Cancer Insitute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Samir S Parekh
- Tisch Cancer Insitute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Shambavi Richard
- Tisch Cancer Insitute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Joshua Richter
- Tisch Cancer Insitute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Larysa Sanchez
- Tisch Cancer Insitute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Ajai Chari
- Tisch Cancer Insitute, Icahn School of Medicine at Mount Sinai, New York, New York.
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Preclinical activity and determinants of response of the GPRC5DxCD3 bispecific antibody talquetamab in multiple myeloma. Blood Adv 2021; 5:2196-2215. [PMID: 33890981 DOI: 10.1182/bloodadvances.2020003805] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 03/08/2021] [Indexed: 02/05/2023] Open
Abstract
Cell surface expression levels of GPRC5D, an orphan G protein-coupled receptor, are significantly higher on multiple myeloma (MM) cells, compared with normal plasma cells or other immune cells, which renders it a promising target for immunotherapeutic strategies. The novel GPRC5D-targeting T-cell redirecting bispecific antibody, talquetamab, effectively kills GPRC5D+ MM cell lines in the presence of T cells from both healthy donors or heavily pretreated MM patients. In addition, talquetamab has potent anti-MM activity in bone marrow (BM) samples from 45 patients, including those with high-risk cytogenetic aberrations. There was no difference in talquetamab-mediated killing of MM cells from newly diagnosed, daratumumab-naïve relapsed/refractory (median of 3 prior therapies), and daratumumab-refractory (median of 6 prior therapies) MM patients. Tumor cell lysis was accompanied by T-cell activation and degranulation, as well as production of pro-inflammatory cytokines. High levels of GPRC5D and high effector:target ratio were associated with improved talquetamab-mediated lysis of MM cells, whereas an increased proportion of T cells expressing PD-1 or HLA-DR, and elevated regulatory T-cell (Treg) counts were associated with suboptimal killing. In cell line experiments, addition of Tregs to effector cells decreased MM cell lysis. Direct contact with bone marrow stromal cells also impaired the efficacy of talquetamab. Combination therapy with daratumumab or pomalidomide enhanced talquetamab-mediated lysis of primary MM cells in an additive fashion. In conclusion, we show that the GPRC5D-targeting T-cell redirecting bispecific antibody talquetamab is a promising novel antimyeloma agent. These results provide the preclinical rationale for ongoing studies with talquetamab in relapsed/refractory MM.
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Chimeric Antigen Receptor T Cells for Multiple Myeloma: The Journey So Far-And the Road Ahead. ACTA ACUST UNITED AC 2021; 27:112-118. [PMID: 33750070 DOI: 10.1097/ppo.0000000000000506] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
ABSTRACT Despite improvements in effective therapy, multiple myeloma remains incurable, and virtually all patients will face relapsed disease at some point after diagnosis. The prognosis for relapsed myeloma after developing resistance to anti-CD38 monoclonal antibodies, proteasome inhibitors, immunomodulatory agents, and autologous stem cell transplantation has been poor; however, the development of immune effector cell therapy with chimeric antigen receptor (CAR) T cells may dramatically improve the outlook for patients, although none of these therapies are approved for MM to date. Herein, we review the development and history of CAR T-cell therapy for multiple myeloma, mechanisms of resistance, and strategies to improve outcomes with CAR T therapy.
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Huang H, Wu HW, Hu YX. Current advances in chimeric antigen receptor T-cell therapy for refractory/relapsed multiple myeloma. J Zhejiang Univ Sci B 2020; 21:29-41. [PMID: 31898440 DOI: 10.1631/jzus.b1900351] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Multiple myeloma (MM), considered an incurable hematological malignancy, is characterized by its clonal evolution of malignant plasma cells. Although the application of autologous stem cell transplantation (ASCT) and the introduction of novel agents such as immunomodulatory drugs (IMiDs) and proteasome inhibitors (PIs) have doubled the median overall survival to eight years, relapsed and refractory diseases are still frequent events in the course of MM. To achieve a durable and deep remission, immunotherapy modalities have been developed for relapsed/refractory multiple myeloma (RRMM). Among these approaches, chimeric antigen receptor (CAR) T-cell therapy is the most promising star, based on the results of previous success in B-cell neoplasms. In this immunotherapy, autologous T cells are engineered to express an artificial receptor which targets a tumor-associated antigen and initiates the T-cell killing procedure. Tisagenlecleucel and Axicabtagene, targeting the CD19 antigen, are the two pacesetters of CAR T-cell products. They were approved by the US Food and Drug Administration (FDA) in 2017 for the treatment of acute lymphocytic leukemia (ALL) and diffuse large B-cell lymphoma (DLBCL). Their development enabled unparalleled efficacy in combating hematopoietic neoplasms. In this review article, we summarize six promising candidate antigens in MM that can be targeted by CARs and discuss some noteworthy studies of the safety profile of current CAR T-cell therapy.
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Affiliation(s)
- He Huang
- Bone Marrow Transplantation Center, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China.,Institute of Hematology, Zhejiang University, Hangzhou 310058, China
| | - Heng-Wei Wu
- Bone Marrow Transplantation Center, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China.,Institute of Hematology, Zhejiang University, Hangzhou 310058, China
| | - Yong-Xian Hu
- Bone Marrow Transplantation Center, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China.,Institute of Hematology, Zhejiang University, Hangzhou 310058, China
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36
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van der Schans JJ, van de Donk NWCJ, Mutis T. Dual Targeting to Overcome Current Challenges in Multiple Myeloma CAR T-Cell Treatment. Front Oncol 2020; 10:1362. [PMID: 32850436 PMCID: PMC7419675 DOI: 10.3389/fonc.2020.01362] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 06/29/2020] [Indexed: 12/14/2022] Open
Abstract
In the era of highly promising novel targeted-immunotherapy strategies for multiple myeloma (MM), the first series of clinical trials with CAR T-cells targeting the plasma cell-specific B-cell maturation antigen (BCMA) have shown excellent response rates. In the long-term, however, MM appears to escape the therapy likely due to initial low and heterogeneous expression or downregulation of BCMA expression. Several other molecules targeted by CAR T-cells in MM are expressed at high levels on MM cells, but many of these attractive targets are also expressed on various, sometimes vital non-malignant cells, posing major risks for on-target, off-tumor side effects. CAR T-cell therapy for MM therefore faces two urgent challenges: (i) improving the efficacy of BCMA CAR T-cells and (ii) establishing a MM-selectivity even when CAR T-cells are directed against not entirely MM-specific target antigens. In this review, we will outline the current attempts to tackle these challenges, with a specific focus on how dual CAR targeting might be applied to tackle both issues.
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Affiliation(s)
| | | | - Tuna Mutis
- Department of Hematology, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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37
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Smith EL, Harrington K, Staehr M, Masakayan R, Jones J, Long TJ, Ng KY, Ghoddusi M, Purdon TJ, Wang X, Do T, Pham MT, Brown JM, De Larrea CF, Olson E, Peguero E, Wang P, Liu H, Xu Y, Garrett-Thomson SC, Almo SC, Wendel HG, Riviere I, Liu C, Sather B, Brentjens RJ. GPRC5D is a target for the immunotherapy of multiple myeloma with rationally designed CAR T cells. Sci Transl Med 2020; 11:11/485/eaau7746. [PMID: 30918115 DOI: 10.1126/scitranslmed.aau7746] [Citation(s) in RCA: 211] [Impact Index Per Article: 52.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 12/14/2018] [Accepted: 03/08/2019] [Indexed: 12/12/2022]
Abstract
Early clinical results of chimeric antigen receptor (CAR) T cell therapy targeting B cell maturation antigen (BCMA) for multiple myeloma (MM) appear promising, but relapses associated with residual low-to-negative BCMA-expressing MM cells have been reported, necessitating identification of additional targets. The orphan G protein-coupled receptor, class C group 5 member D (GPRC5D), normally expressed only in the hair follicle, was previously identified as expressed by mRNA in marrow aspirates from patients with MM, but confirmation of protein expression remained elusive. Using quantitative immunofluorescence, we determined that GPRC5D protein is expressed on CD138+ MM cells from primary marrow samples with a distribution that was similar to, but independent of, BCMA. Panning a human B cell-derived phage display library identified seven GPRC5D-specific single-chain variable fragments (scFvs). Incorporation of these into multiple CAR formats yielded 42 different constructs, which were screened for antigen-specific and antigen-independent (tonic) signaling using a Nur77-based reporter system. Nur77 reporter screen results were confirmed in vivo using a marrow-tropic MM xenograft in mice. CAR T cells incorporating GPRC5D-targeted scFv clone 109 eradicated MM and enabled long-term survival, including in a BCMA antigen escape model. GPRC5D(109) is specific for GPRC5D and resulted in MM cell line and primary MM cytotoxicity, cytokine release, and in vivo activity comparable to anti-BCMA CAR T cells. Murine and cynomolgus cross-reactive CAR T cells did not cause alopecia or other signs of GPRC5D-mediated toxicity in these species. Thus, GPRC5D(109) CAR T cell therapy shows potential for the treatment of advanced MM irrespective of previous BCMA-targeted therapy.
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Affiliation(s)
- Eric L Smith
- Cellular Therapeutics Center, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.,Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Kim Harrington
- Juno Therapeutics, A Celgene Company, Seattle, WA 98109, USA
| | - Mette Staehr
- Cellular Therapeutics Center, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Reed Masakayan
- Cellular Therapeutics Center, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Jon Jones
- Juno Therapeutics, A Celgene Company, Seattle, WA 98109, USA
| | - Thomas J Long
- Juno Therapeutics, A Celgene Company, Seattle, WA 98109, USA
| | - Khong Y Ng
- Sloan Kettering Institute, New York, NY 10065, USA
| | - Majid Ghoddusi
- Juno Therapeutics, A Celgene Company, Seattle, WA 98109, USA
| | - Terence J Purdon
- Cellular Therapeutics Center, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Xiuyan Wang
- Cell Therapy and Cell Engineering Facility, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Trevor Do
- Juno Therapeutics, A Celgene Company, Seattle, WA 98109, USA
| | - Minh Thu Pham
- Juno Therapeutics, A Celgene Company, Seattle, WA 98109, USA
| | - Jessica M Brown
- Juno Therapeutics, A Celgene Company, Seattle, WA 98109, USA
| | - Carlos Fernandez De Larrea
- Cellular Therapeutics Center, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.,Amyloidosis and Myeloma Unit, Department of Hematology, Hospital Clinic, August Pi i Sunyer Biomedical Research Institute, University of Barcelona, 08036 Barcelona, Spain
| | - Eric Olson
- Juno Therapeutics, A Celgene Company, Seattle, WA 98109, USA
| | | | - Pei Wang
- Eureka Therapeutics, Emeryville, CA 94608, USA
| | - Hong Liu
- Eureka Therapeutics, Emeryville, CA 94608, USA
| | - Yiyang Xu
- Eureka Therapeutics, Emeryville, CA 94608, USA
| | | | - Steven C Almo
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | | | - Isabelle Riviere
- Cell Therapy and Cell Engineering Facility, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Cheng Liu
- Eureka Therapeutics, Emeryville, CA 94608, USA
| | - Blythe Sather
- Juno Therapeutics, A Celgene Company, Seattle, WA 98109, USA
| | - Renier J Brentjens
- Cellular Therapeutics Center, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA. .,Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
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38
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Ahlawat S, Arora R, Sharma R, Sharma U, Kaur M, Kumar A, Singh KV, Singh MK, Vijh RK. Skin transcriptome profiling of Changthangi goats highlights the relevance of genes involved in Pashmina production. Sci Rep 2020; 10:6050. [PMID: 32269277 PMCID: PMC7142143 DOI: 10.1038/s41598-020-63023-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 03/19/2020] [Indexed: 11/09/2022] Open
Abstract
Pashmina, the world's finest natural fiber is derived from secondary hair follicles of Changthangi goats which are domesticated in Ladakh region of Jammu and Kashmir by nomadic pastoralists. Complex epithelial-mesenchymal interactions involving numerous signal molecules and signaling pathways govern hair follicle morphogenesis and mitosis across different species. The present study involved transcriptome profiling of skin from fiber type Changthangi goats and meat type Barbari goats to unravel gene networks and metabolic pathways that might contribute to Pashmina development. In Changthangi goats, 525 genes were expressed at significantly higher levels and 54 at significantly lower levels with fold change >2 (padj < 0.05). Functional annotation and enrichment analysis identified significantly enriched pathways to be formation of the cornified envelope, keratinization and developmental biology. Expression of genes for keratins (KRTs) and keratin-associated proteins (KRTAPs) was observed to be much higher in Changthangi goats. A host of transcriptional regulator genes for hair follicle keratin synthesis such as GPRC5D, PADI3, HOXC13, FOXN1, LEF1 and ELF5 showed higher transcript abundance in Pashmina producing goats. Positive regulation of Wnt signaling pathway and negative regulation of Oncostatin M signaling pathway may be speculated to be important contributors to hair follicle development and hair shaft differentiation in Changthangi goats.
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Affiliation(s)
- Sonika Ahlawat
- ICAR-National Bureau of Animal Genetic Resources, Karnal, India.
| | - Reena Arora
- ICAR-National Bureau of Animal Genetic Resources, Karnal, India
| | - Rekha Sharma
- ICAR-National Bureau of Animal Genetic Resources, Karnal, India
| | - Upasna Sharma
- ICAR-National Bureau of Animal Genetic Resources, Karnal, India
| | - Mandeep Kaur
- ICAR-National Bureau of Animal Genetic Resources, Karnal, India
| | - Ashish Kumar
- ICAR-National Bureau of Animal Genetic Resources, Karnal, India
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Hirabayashi Y, Kim YJ. Roles of GPRC5 family proteins: focusing on GPRC5B and lipid-mediated signalling. J Biochem 2020; 167:541-547. [DOI: 10.1093/jb/mvaa030] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 02/26/2020] [Indexed: 12/15/2022] Open
Abstract
Abstract
In the past decade, physiological roles and molecular functions of GPRC5 family receptors, originally identified as retinoic acid-induced gene products, have been uncovered, even though their intrinsic agonists are still a mystery. They are differentially distributed in certain tissues and cells in the body suggesting that cell-type-specific regulations and functions are significant. Molecular biological approaches and knockout mouse studies reveal that GPRC5 family proteins have pivotal roles in cancer progression and control of metabolic homeostasis pathways. Remarkably, GPRC5B-mediated tyrosine-phosphorylation signalling cascades play a critical role in development of obesity and insulin resistance through dynamic sphingolipid metabolism.
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Affiliation(s)
| | - Yeon-Jeong Kim
- Department of Biochemistry, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi 409-3898, Japan
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40
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Premanand A, Rajkumari BR. In silico analysis of gene expression data from bald frontal and haired occipital scalp to identify candidate genes in male androgenetic alopecia. Arch Dermatol Res 2019; 311:815-824. [DOI: 10.1007/s00403-019-01973-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 07/06/2019] [Accepted: 08/30/2019] [Indexed: 12/28/2022]
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Kodama T, Kochi Y, Nakai W, Mizuno H, Baba T, Habu K, Sawada N, Tsunoda H, Shima T, Miyawaki K, Kikushige Y, Mori Y, Miyamoto T, Maeda T, Akashi K. Anti-GPRC5D/CD3 Bispecific T-Cell-Redirecting Antibody for the Treatment of Multiple Myeloma. Mol Cancer Ther 2019; 18:1555-1564. [PMID: 31270154 DOI: 10.1158/1535-7163.mct-18-1216] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 04/29/2019] [Accepted: 06/28/2019] [Indexed: 11/16/2022]
Abstract
Although treatment advances over recent decades have significantly improved survival of patients with multiple myeloma, there is still an unmet medical need for more effective treatments. In this study, we identified G-protein-coupled receptor family C group 5 member D (GPRC5D) expression on the surface of malignant cells involved in multiple myeloma, but except for plasma cells and B cells, not at appreciable levels on normal hematopoietic cells and bone marrow progenitors, including hematopoietic stem cells. In addition, we constructed IgG-based anti-GPRC5D/CD3 bispecific T-cell-redirecting antibodies (GPRC5D TRAB), which suppressed the tumor growth of GPRC5D-positive myeloma cells through the activation of T cells in vitro and in vivo in xenograft models. Collectively, these findings suggest that GPRC5D is an antigen specific to multiple myeloma and a potential target of TRAB therapy.
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Affiliation(s)
- Tatsushi Kodama
- Chugai Pharmabody Research Pte. Ltd., Singapore. .,Research Division, Chugai Pharmaceutical Co., Ltd., Kamakura, Kanagawa, Japan
| | - Yu Kochi
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Waka Nakai
- Research Division, Chugai Pharmaceutical Co., Ltd., Kamakura, Kanagawa, Japan
| | - Hideaki Mizuno
- Research Division, Chugai Pharmaceutical Co., Ltd., Kamakura, Kanagawa, Japan
| | - Takeshi Baba
- Research Division, Chugai Pharmaceutical Co., Ltd., Kamakura, Kanagawa, Japan
| | - Kiyoshi Habu
- Research Division, Chugai Pharmaceutical Co., Ltd., Kamakura, Kanagawa, Japan
| | - Noriaki Sawada
- Research Division, Chugai Pharmaceutical Co., Ltd., Kamakura, Kanagawa, Japan
| | - Hiroyuki Tsunoda
- Research Division, Chugai Pharmaceutical Co., Ltd., Kamakura, Kanagawa, Japan
| | - Takahiro Shima
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Kohta Miyawaki
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Yoshikane Kikushige
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Yasuo Mori
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Toshihiro Miyamoto
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Takahiro Maeda
- Center for Cellular and Molecular Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Koichi Akashi
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan.,Center for Cellular and Molecular Medicine, Kyushu University Hospital, Fukuoka, Japan
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Muhammad SA, Fatima N, Paracha RZ, Ali A, Chen JY. A systematic simulation-based meta-analytical framework for prediction of physiological biomarkers in alopecia. ACTA ACUST UNITED AC 2019; 26:2. [PMID: 30993080 PMCID: PMC6449998 DOI: 10.1186/s40709-019-0094-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 03/20/2019] [Indexed: 01/13/2023]
Abstract
Background Alopecia or hair loss is a complex polygenetic and psychologically devastating disease affecting millions of men and women globally. Since the gene annotation and environmental knowledge is limited for alopecia, a systematic analysis for the identification of candidate biomarkers is required that could provide potential therapeutic targets for hair loss therapy. Results We designed an interactive framework to perform a meta-analytical study based on differential expression analysis, systems biology, and functional proteomic investigations. We analyzed eight publicly available microarray datasets and found 12 potential candidate biomarkers including three extracellular proteins from the list of differentially expressed genes with a p-value < 0.05. After expression profiling and functional analysis, we studied protein–protein interactions and observed functional associations of source proteins including WIF1, SPON1, LYZ, GPRC5B, PTPRE, ZFP36L2, HBB, PHF15, LMCD1, KRT35 and VAV3 with target proteins including APCDD1, WNT1, WNT3A, SHH, ESRI, TGFB1, and APP. Pathway analysis of these molecules revealed their role in major physiological reactions including protein metabolism, signal transduction, WNT, BMP, EDA, NOTCH and SHH pathways. These pathways regulate hair growth, hair follicle differentiation, pigmentation, and morphogenesis. We studied the regulatory role of β-catenin, Nf-kappa B, cytokines and retinoic acid in the development of hair growth. Therefore, the differential expression of these significant proteins would affect the normal level and could cause aberrations in hair growth. Conclusion Our integrative approach helps to prioritize the biomarkers that ultimately lessen the economic burden of experimental studies. It will also be valuable to discover mutants in genomic data in order to increase the identification of new biomarkers for similar problems. Electronic supplementary material The online version of this article (10.1186/s40709-019-0094-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Syed Aun Muhammad
- 1Institute of Molecular Biology and Biotechnology, Bahauddin Zakariya University, Multan, 60800 Pakistan
| | - Nighat Fatima
- 2Department of Pharmacy, COMSATS Institute of Information Technology, Abbottabad, 22060 Pakistan
| | - Rehan Zafar Paracha
- 3Research Center of Modeling and Simulation (RCMS), Department of Computational Sciences, National University of Sciences and Technology (NUST), Islamabad, 44000 Pakistan
| | - Amjad Ali
- 4Atta-ur-Rahman School of Applied Biosciences (ASAB), National University of Sciences and Technology (NUST), Islamabad, 44000 Pakistan
| | - Jake Y Chen
- 5Informatics Institute, School of Medicine, The University of Alabama (UAB), Birmingham, USA
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Rajkumar P, Cha B, Yin J, Arend LJ, Păunescu TG, Hirabayashi Y, Donowitz M, Pluznick JL. Identifying the localization and exploring a functional role for Gprc5c in the kidney. FASEB J 2018; 32:2046-2059. [PMID: 29196502 DOI: 10.1096/fj.201700610rr] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The investigation of orphan GPCRs (GPRs) has the potential to uncover novel insights into whole animal physiology. In this study, our goal was to determine the renal localization of Gprc5c, a receptor that we previously reported to be highly expressed in murine whole kidney, and to examine physiologic parameters in Gprc5c knockout (KO) mice to gain insight into function. Gprc5c localized to the apical membrane of renal proximal tubules (PTs) in mice, rats, and humans. With the comparison of Gprc5c wild-type (WT) and KO mice, we found that Gprc5c KO mice have altered acid-base homeostasis. Specifically, Gprc5c KO mice have lower blood pH and higher urine pH compared with WT mice, with a reduced level of titratable acids in their urine. In an in vitro GPCR internalization assay, we observed that Gprc5c internalization (an index of activation) was triggered by alkaline extracellular pH. Furthermore, with the use of an in vitro BCECF assay, we observed that Gprc5c increases Na+/H+ exchanger 3 (NHE3) activity at alkaline pH. We also find that the NHE3 activity is reduced in Gprc5c KO mice by 2 photon imaging in seminaphthorhodafluors (SNARF)-4F-loaded kidney sections. NHE3 is a primary contributor to apical transport of H+ in the renal PT. Together, these data imply that Gprc5c modulates the renal contribution to systemic pH homeostasis, at least in part, by taking part in the regulation of NHE3.-Rajkumar, P., Cha, B., Yin, J., Arend, L. J., Păunescu, T. G., Hirabayashi, Y., Donowitz, M., Pluznick, J. L. Identifying the localization and exploring a functional role for Gprc5c in the kidney.
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Affiliation(s)
- Premraj Rajkumar
- Department of Physiology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Boyoung Cha
- Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jianyi Yin
- Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Lois J Arend
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Teodor G Păunescu
- Division of Nephrology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Yoshio Hirabayashi
- Laboratory for Molecular Membrane Neuroscience, RIKEN Brain Science Institute, Saitama, Japan
| | - Mark Donowitz
- Department of Physiology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jennifer L Pluznick
- Department of Physiology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Gao Y, Wang X, Yan H, Zeng J, Ma S, Niu Y, Zhou G, Jiang Y, Chen Y. Comparative Transcriptome Analysis of Fetal Skin Reveals Key Genes Related to Hair Follicle Morphogenesis in Cashmere Goats. PLoS One 2016; 11:e0151118. [PMID: 26959817 PMCID: PMC4784850 DOI: 10.1371/journal.pone.0151118] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 02/22/2016] [Indexed: 11/18/2022] Open
Abstract
Cashmere goat skin contains two types of hair follicles (HF): primary hair follicles (PHF) and secondary hair follicles (SHF). Although multiple genetic determinants associated with HF formation have been identified, the molecules that determine the independent morphogenesis of HF in cashmere goats remain elusive. The growth and development of SHF directly influence the quantity and quality of cashmere production. Here, we report the transcriptome profiling analysis of nine skin samples from cashmere goats using 60- and 120-day-old embryos (E60 and E120, respectively), as well as newborns (NB), through RNA-sequencing (RNA-seq). HF morphological changes indicated that PHF were initiated at E60, with maturation from E120, while differentiation of SHF was identified at E120 until formation of cashmere occurred after birth (NB). The RNA-sequencing analysis generated over 20.6 million clean reads from each mRNA library. The number of differentially expressed genes (DEGs) in E60 vs. E120, E120 vs. NB, and E60 vs. NB were 1,024, 0 and 1,801, respectively, indicating that no significant differences were found at transcriptomic levels between E120 and NB. Key genes including B4GALT4, TNC, a-integrin, and FGFR1, were up-regulated and expressed in HF initiation from E60 to E120, while regulatory genes such as GPRC5D, PAD3, HOXC13, PRR9, VSIG8, LRRC15, LHX2, MSX-2, and FOXN1 were up-regulated and expressed in HF keratinisation and hair shaft differentiation from E120 and NB to E60. Several genes belonging to the KRT and KRTAP gene families were detected throughout the three HF developmental stages. The transcriptional trajectory analyses of all DEGs indicated that immune privilege, glycosaminoglycan biosynthesis, extracellular matrix receptor interaction, and growth factor receptors all played dominant roles in the epithelial-mesenchymal interface and HF formation. We found that the Wnt, transforming growth factor-beta/bone morphogenetic protein, and Notch family members played vital roles in HF differentiation and maturation. The DEGs we found could be attributed to the generation and development of HF, and thus will be critically important for improving the quantity and quality of fleece production in animals for fibres.
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Affiliation(s)
- Ye Gao
- College of Animal Science and Technology, Northwest A&F University, Yangling, People’s Republic of China
- College of Life Science, Yulin University, Yulin, People’s Republic of China
| | - Xiaolong Wang
- College of Animal Science and Technology, Northwest A&F University, Yangling, People’s Republic of China
| | - Hailong Yan
- College of Animal Science and Technology, Northwest A&F University, Yangling, People’s Republic of China
- College of Life Science, Yulin University, Yulin, People’s Republic of China
| | - Jie Zeng
- College of Animal Science and Technology, Northwest A&F University, Yangling, People’s Republic of China
| | - Sen Ma
- College of Animal Science and Technology, Northwest A&F University, Yangling, People’s Republic of China
| | - Yiyuan Niu
- College of Animal Science and Technology, Northwest A&F University, Yangling, People’s Republic of China
| | - Guangxian Zhou
- College of Animal Science and Technology, Northwest A&F University, Yangling, People’s Republic of China
| | - Yu Jiang
- College of Animal Science and Technology, Northwest A&F University, Yangling, People’s Republic of China
| | - Yulin Chen
- College of Animal Science and Technology, Northwest A&F University, Yangling, People’s Republic of China
- * E-mail:
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Le Vu P, Takatori R, Iwamoto T, Akagi Y, Satsu H, Totsuka M, Chida K, Sato K, Shimizu M. Effects of Food-Derived Collagen Peptides on the Expression of Keratin and Keratin-Associated Protein Genes in the Mouse Skin. Skin Pharmacol Physiol 2015; 28:227-35. [DOI: 10.1159/000369830] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 11/08/2014] [Indexed: 11/19/2022]
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Atamaniuk J, Gleiss A, Porpaczy E, Kainz B, Grunt TW, Raderer M, Hilgarth B, Drach J, Ludwig H, Gisslinger H, Jaeger U, Gaiger A. Overexpression of G protein-coupled receptor 5D in the bone marrow is associated with poor prognosis in patients with multiple myeloma. Eur J Clin Invest 2012; 42:953-60. [PMID: 22591013 DOI: 10.1111/j.1365-2362.2012.02679.x] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND G protein-coupled receptor 5D (GPRC5D) is a novel surface receptor. As this new subtype of G protein-coupled receptors was discovered, little is known about the role of this gene. MATERIALS AND METHODS In this retrospective study, we investigated GPRC5D mRNA expression by real-time polymerase chain reaction (RT-PCR) in bone marrow (BM) of 48 patients with multiple myeloma (MM). RESULTS Highly variable levels of GPRC5D (median, 288; quartiles, 17-928) were detected in patients with MM, whereas only low expression was detected in normal tissues (median, 1; quartiles, 1-23). High mRNA expression of GPRC5D correlated positively with high plasma cell count in bone marrow (r = 0·64, P < 0·001), high β(2) -microglobulin (r = 0·42, P = 0·003) and poor-risk cytogenetics: deletion 13q14 (rb-1), P = 0·003; and 14q32 translocation t(4;14)(p16;q32), P = 0·029. GPRC5D mRNA expression showed a significant correlation with overall survival (P = 0·031). The estimated overall survival of patients expressing GPRC5D above or below the median of 288 was 43·9% vs. 70·2% at 48 months. Here, we report, for the first time, the association of GPRC5D expression and cancer. CONCLUSIONS Overexpression in poor-risk myeloma, low expression in normal tissues and cell surface expression identify GPRC5D as a potential novel cancer antigen. Our data demonstrate that GPRC5D is a prognostic factor in MM correlating with other major risk factors.
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Affiliation(s)
- Johanna Atamaniuk
- Department of Medicine I, Division of Hematology and Hemostaseology, Medical University Vienna, Austria
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Judah D, Rudkouskaya A, Wilson R, Carter DE, Dagnino L. Multiple roles of integrin-linked kinase in epidermal development, maturation and pigmentation revealed by molecular profiling. PLoS One 2012; 7:e36704. [PMID: 22574216 PMCID: PMC3344928 DOI: 10.1371/journal.pone.0036704] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2012] [Accepted: 04/05/2012] [Indexed: 02/06/2023] Open
Abstract
Integrin-linked kinase (ILK) is an important scaffold protein that mediates a variety of cellular responses to integrin stimulation by extracellular matrix proteins. Mice with epidermis-restricted inactivation of the Ilk gene exhibit pleiotropic phenotypic defects, including impaired hair follicle morphogenesis, reduced epidermal adhesion to the basement membrane, compromised epidermal integrity, as well as wasting and failure to thrive leading to perinatal death. To better understand the underlying molecular mechanisms that cause such a broad range of alterations, we investigated the impact of Ilk gene inactivation on the epidermis transcriptome. Microarray analysis showed over 700 differentially regulated mRNAs encoding proteins involved in multiple aspects of epidermal function, including keratinocyte differentiation and barrier formation, inflammation, regeneration after injury, and fundamental epidermal developmental pathways. These studies also revealed potential effects on genes not previously implicated in ILK functions, including those important for melanocyte and melanoblast development and function, regulation of cytoskeletal dynamics, and homeobox genes. This study shows that ILK is a critical regulator of multiple aspects of epidermal function and homeostasis, and reveals the previously unreported involvement of ILK not only in epidermal differentiation and barrier formation, but also in melanocyte genesis and function.
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Affiliation(s)
- David Judah
- Department of Physiology and Pharmacology, University of Western Ontario, and Children's Health Research Institute and Lawson Health Research Institute, London, Ontario, Canada
| | - Alena Rudkouskaya
- Department of Physiology and Pharmacology, University of Western Ontario, and Children's Health Research Institute and Lawson Health Research Institute, London, Ontario, Canada
| | - Ryan Wilson
- Department of Physiology and Pharmacology, University of Western Ontario, and Children's Health Research Institute and Lawson Health Research Institute, London, Ontario, Canada
| | - David E. Carter
- London Regional Genomics Centre, University of Western Ontario, London, Ontario, Canada
| | - Lina Dagnino
- Department of Physiology and Pharmacology, University of Western Ontario, and Children's Health Research Institute and Lawson Health Research Institute, London, Ontario, Canada
- Department of Paediatrics, University of Western Ontario, London, Ontario, Canada
- * E-mail:
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Sano T, Kim YJ, Oshima E, Shimizu C, Kiyonari H, Abe T, Higashi H, Yamada K, Hirabayashi Y. Comparative characterization of GPRC5B and GPRC5C LacZ knockin mice; behavioral abnormalities in GPRC5B-deficient mice. Biochem Biophys Res Commun 2011; 412:460-5. [DOI: 10.1016/j.bbrc.2011.07.118] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2011] [Accepted: 07/29/2011] [Indexed: 11/15/2022]
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Kurtenbach S, Mayer C, Pelz T, Hatt H, Leese F, Neuhaus EM. Molecular evolution of a chordate specific family of G protein-coupled receptors. BMC Evol Biol 2011; 11:234. [PMID: 21827690 PMCID: PMC3238225 DOI: 10.1186/1471-2148-11-234] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2011] [Accepted: 08/09/2011] [Indexed: 11/23/2022] Open
Abstract
Background Chordate evolution is a history of innovations that is marked by physical and behavioral specializations, which led to the development of a variety of forms from a single ancestral group. Among other important characteristics, vertebrates obtained a well developed brain, anterior sensory structures, a closed circulatory system and gills or lungs as blood oxygenation systems. The duplication of pre-existing genes had profound evolutionary implications for the developmental complexity in vertebrates, since mutations modifying the function of a duplicated protein can lead to novel functions, improving the evolutionary success. Results We analyzed here the evolution of the GPRC5 family of G protein-coupled receptors by comprehensive similarity searches and found that the receptors are only present in chordates and that the size of the receptor family expanded, likely due to genome duplication events in the early history of vertebrate evolution. We propose that a single GPRC5 receptor coding gene originated in a stem chordate ancestor and gave rise by duplication events to a gene family comprising three receptor types (GPRC5A-C) in vertebrates, and a fourth homologue present only in mammals (GPRC5D). Additional duplications of GPRC5B and GPRC5C sequences occurred in teleost fishes. The finding that the expression patterns of the receptors are evolutionarily conserved indicates an important biological function of these receptors. Moreover, we found that expression of GPRC5B is regulated by vitamin A in vivo, confirming previous findings that linked receptor expression to retinoic acid levels in tumor cell lines and strengthening the link between the receptor expression and the development of a complex nervous system in chordates, known to be dependent on retinoic acid signaling. Conclusions GPRC5 receptors, a class of G protein-coupled receptors with unique sequence characteristics, may represent a molecular novelty that helped non-chordates to become chordates.
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Affiliation(s)
- Stefan Kurtenbach
- 1Department of Cell Physiology, Ruhr University Bochum, Universitaetsstrasse150, 44801 Bochum, Germany
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Montmayeur JP, Fenech C, Kusumakshi S, Laugerette F, Liu Z, Wiencis A, Boehm U. Screening for G-protein-coupled receptors expressed in mouse taste papillae. FLAVOUR FRAG J 2011. [DOI: 10.1002/ffj.2043] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
| | - Claire Fenech
- UMR6265 CNRS, Centre des Sciences du Goût et de l'Alimentation; 15 Rue H. Picardet; F-21000; Dijon; France
| | - Soumya Kusumakshi
- Institute for Neural Signal Transduction, Centre for Molecular Neurobiology; Falkenried 94; D-20253; Hamburg; Germany
| | - Fabienne Laugerette
- General Olfaction and Sensing Programme on a European Level, Centre des Sciences du Goût et de l'Alimentation; 15 Rue H. Picardet; F-21000; Dijon; France
| | - Zhenhui Liu
- UMR6265 CNRS, Centre des Sciences du Goût et de l'Alimentation; 15 Rue H. Picardet; F-21000; Dijon; France
| | - Anna Wiencis
- General Olfaction and Sensing Programme on a European Level, Centre des Sciences du Goût et de l'Alimentation; 15 Rue H. Picardet; F-21000; Dijon; France
| | - Ulrich Boehm
- Institute for Neural Signal Transduction, Centre for Molecular Neurobiology; Falkenried 94; D-20253; Hamburg; Germany
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