What is meant by t-cell redirecting therapy?

What is meant by T cell redirecting therapy? What currently approved therapies for relapsed refractory multiple myeloma are considered T cell redirecting therapies?

So t cell redirecting therapy basically just means we’re using treatment that turns your T cells on to the tumor or the cancer. So for multiple myeloma, those would be things like our CAR-T cell therapies and our bispecific T cell engagers those would all be considered t cell redirecting therapies.

So what's approved now is ida-cel or ABECMA and cilta-cel or CARVYKTI These are the two CAR-T cell products that are approved. These are approved for patients who've had four or more prior lines of therapy and are triple class exposed the bispecific t cell engager that's approved now is teclistamab. And again, it's the same indication

On April 5th, 2024, the FDA approved new indications for both CARVYKTI and ABECMA. The FDA approved CARVIKTY for the treatment of adult patients with relapsed or refractory multiple myeloma who have received at least one prior line of therapy, including a proteasome inhibitor and an immunomodulatory agent, and who are refractory to lenalidomide.

The FDA approved ABECMA for the treatment of adult patients with relapsed or refractory multiple myeloma after two or more prior lines of therapy, including a proteasome inhibitor and an immunomodulatory agent, and an anti Cd38 monoclonal antibody.

Talvey and Elrexfio received FDA approval in August 2023 for myeloma patients who have received at least four prior lines of therapy, including a proteasome inhibitor, an immunomodulatory agent, and an anti Cd38 monoclonal antibody.

when you think of cancer, we have a variety of different drugs that we can give to kill cancer cells. But there is also a different approach to treating cancer, which is using immunotherapy.

So cancer cells can get really smart and sneaky and evade the immune system. Right. The immune system should normally be recognizing cancer cells as being foreign and attacking them. But the cancer cells find ways to avoid that.

So immunotherapy is geared towards training the immune system in some way or helping the immune system fight the cancer.

we can do this in a variety of different ways. But T cell redirection is definitely very popular these days and it's showing amazing, amazing results. So what we're doing is in some way we are training a t cell, which is a special kind of white blood cell.

We're training that t cell, how to fight the cancer cell.

we can do that in different ways.

So I'm going to talk about the two main forms of t cell redirecting therapies that are available these days.

One is called CAR-T, and the other one is Bispecific antibodies.

with CAR-T, what we do is in a nutshell, we take someone's T cells, we harvest someone's T cells, and we basically modify those T cells to make them better at recognizing the cancer cells.

then we reintroduce those T cells back to the patient And essentially those T cells are now better able to recognize the cancer cell and go in and attack those cells specifically.

And so that's the first approach. The other approach is with these bispecific antibodies.

So in this case what we do, there's no harvesting involved of the patient's own cells.

We have we manufacture in the lab, we manufacture an antibody. An antibody has a shape, kind of like a Y.

so one arm of the antibody is going to be specialized in recognizing an antigen in the myeloma cell. So a specific protein in the myeloma cell. And then the other arm of the antibody is going to be specialized in attaching to a T cell.

Right. so then the antibody is bringing the two together, a myeloma cell and a T cell.

it increases the chances that the T cell will now recognize that that myeloma cell as being foreign and and attacking the cell.

So it's two similar ways of doing the same thing. But what we're going back to the name of this concept T cell redirection.

We're trying to give hints to the T cells as to where the myeloma cells might be. And this applies to any any form of cancer, really.

Well, I mean, I think this is basically a class of drugs that redirect t cells, right?

So t cells are immune cells that are important in controlling cancer growth. They're important in lots of different malignancies.

And t cell redirecting therapy is a class of currently mostly monoclonal antibodies that are directed at myeloma cells and also at a t cell molecule called CD3, which is part of the t cell activating receptor or, you know, the protein on the surface of T cells that leads to the t cell activation.

And the idea is that you bind a molecule on the myeloma cell and bring in the t cell, activate the t cell, and the t cell kills the myeloma cell. And there's three different targets that are currently being evaluated clinically. I would say that the three that are showing a lot of clinical promise, let's put it that way at this point, others that have had less data reported, the three targets are BCMA.

Of course, GPRC5D and FCRH5

To learn more about the drugs mentioned in this video, visit the link in the description.