B cell maturation antigen (BCMA) targeted immunotherapy can treat multiple myeloma. This therapy targets cancer cells to slow or stop their growth and prevent cells from growing out of control. BCMA-targeted treatment attack a specific antigen that is heavily present in myeloma cells.

Multiple myeloma is currently incurable. However, treatment can allow many people to enter remission, a state where the disease does not progress for many years. For some, remission is difficult to achieve. For others, their cancer does not respond well to standard treatments.

BCMA-targeted treatment for multiple myeloma can prolong survival. It is especially beneficial to people with certain high risk forms of myeloma, whose outlook has historically been poor. Doctors refer to myeloma as both multiple myeloma and myeloma.

Read on to learn more about BCMA-targeted treatment for multiple myeloma, including how it works and its different types.

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While treatment can often control myeloma for a time, this type of cancer tends to come back. When it does, it is often aggressive and resistant to treatment. A 2021 paper reports that, in people who experience a recurrence and become resistant to standard therapies, the median survival time is just 5.6 months.

Traditional cancer treatments such as chemotherapy target a wide range of cells, both cancerous and healthy. This can kill healthy cells as well as cancer cells and cause many side effects.

BCMA-targeted treatment is a type of chimeric antigen receptor (CAR T) cell therapy. This refers to a class of anticancer treatment.

Therapies that target BCMA specifically attack cancer cells, killing them, slowing their growth, and reducing the side effects of therapy in people living with cancer. This treatment is currently available to people with cancer that has come back or not responded to other treatments.

Learn more about multiple myeloma.

BCMA-targeted treatment and refractory multiple myeloma

Research suggests BCMA-targeted treatment may improve survival for people with refractory multiple myeloma, including those who have previously been on multiple lines of treatment. Refractory multiple myeloma refers to cancer that has stopped responding to therapies.

A 2021 case report followed two people with refractory multiple myeloma. Both had received anti-BCMA CAR T cell treatment. Researchers found that within 30 days, the participants had a complete response to treatment, which means that all signs of cancer disappeared. At 4 and 10 months, the complete response persisted, and follow-up at 36 months showed there were still no signs of cancer.

Predicting individual survival times can be difficult since survival rates depend on factors such as overall health, age, the type of BCMA-targeted therapy a person has, and whether their cancer is causing organ damage. Still, the data on BCMA-targeted treatment offers hope, and further research may identify strategies for increasing its effectiveness.

Multiple myeloma begins in the B cells of the immune system.

B cell maturation antigen (BCMA) helps regulate the growth and survival of B cells.

BCMA is heavily present on myeloma cells and only minimally present on other cells, such as stem cells. This means that BCMA-targeted therapy could help slow the growth of myeloma since it begins in the B cells. Also, BCMA can make for a useful marker in monitoring the response to therapy in people with multiple myeloma.

Cancer happens when cells grow out of control. BCMA may help cancer cells live longer or grow more quickly.

Anti-BCMA treatments target the B cell maturation antigen to kill cancer cells. This can slow cancer growth and potentially even help a person become cancer-free. BCMA-targeting treatments work in several ways, but the fundamental goal of killing cancer cells and reducing side effects is the same.

Soluble BCMA

There is also a soluble form of BCMA called sBCMA. In people with multiple myeloma, the serum levels of sBCMA are higher than in individuals who do not have the condition.

This high level of sBCMA itself can link to an increase in the burden of disease and a less positive therapy response and outlook. However, research suggests that a good response to BCMA-targeted therapy may substantially lower the levels of serum sBCMA.

Three general types of BCMA-targeted treatments may help. These include:

Antibody-drug conjugates (ADCs)

This group of drugs uses monoclonal antibodies to bind to the surface of myeloma cells and induce cell death.

The monoclonal antibodies are very specific and should only bind to tumor cells with a particular antigen. This binding technique minimizes the number of healthy cells affected by this treatment.

People may typically require treatment with ADCs every 3 weeks.

An example of an ADC is Blenrep.

Bispecific T cell engagers (BiTEs)

These drugs bind to B and plasma cells that express BCMA and T cells that express CD3ɛ. T cells are part of the immune system and help the body fight cancer.

BiTEs allow a T cell and myeloma cell to cross-link, and this action activates the T cell to produce cytotoxic cytokines, substances that can induce cell death.

BiTE usually requires weekly treatments.

CAR T cells

This is an innovative therapy type that combines the advantages of using specific monoclonal antibodies and CAR T cells.

Many clinical trials show that CAR T cells are effective at treating people with relapsed or refractory B cell neoplasms.

This one-time therapy can work alongside chemotherapy but usually requires a hospital stay.

Research opportunities and challenges

Many of these treatments are currently in the clinical trial stage. As researchers explore BCMA therapy options, more treatments may become available.

Each BCMA-targeted therapy comes with its advantages and drawbacks. It is unclear which anti-BCMA approach is better than the others, which can make deciding on the right therapy course challenging.

BCMA-targeted treatment is a new but promising therapy. Ongoing clinical trials seek to better understand how it works, whether additional treatments such as chemotherapy can increase its effectiveness, and which types of myeloma respond best to BCMA-targeted therapy.

People with myeloma should seek help from their doctor and ask for guidance on treatment options, including experimental treatments and clinical trials. BCMA-targeted therapies may increase life expectancy and could be one of the only treatment options available for people with recurrent or high risk cancers.

Even though myeloma is not typically curable, people often live for many years after receiving this diagnosis. It is also commonly possible for a person to experience many years in which they are free of the disease.