Teclistamab

B-cell maturation antigen (BCMA) is a member of the tumour necrosis factor family of receptors expressed on the surface of B-lineage cells, as well as late-stage B cells and plasma cells. BCMA interacts with its ligands to activate survival signalling pathways such as NF-kappa B, STAT3, ERK1/2, and AKT/PI3K, and upregulates anti-apoptotic proteins to regulate B-cell maturation, proliferation, and survival. Besides B cells, BCMA is also widely expressed on multiple myeloma (MM) cells and supports the survival of MM cells, making it a promising therapeutic target for therapeutic agents for MM.

Teclistamab is a bispecific T cell engaging antibody that targets the CD3 receptor, which is expressed on the surface of T cells, and BCMA, which is expressed on malignant cells. Due to its dual binding sites, teclistamab is able to draw CD3+ T cells in close proximity to BCMA+ cells, resulting in T cell activation and T cell-mediated cytotoxicity, which is mediated by secreted perforin and various granzymes stored in the secretory vesicles of cytotoxic T cells. This effect occurs without regard to T cell receptor specificity or reliance on major histocompatibility complex (MHC) Class 1 molecules on the surface of antigen presenting cells. Ultimately, teclistamab promotes the lysis and death of BCMA+ cells.