BCMA (B-cell Maturation Antigen)
2025. 5. 16. 19:26
๋ฐ˜์‘ํ˜•

๐ŸŽฏ BCMA ๊ฐœ์š”

ํ•ญ๋ชฉ์„ค๋ช…
์ „์ฒด ์ด๋ฆ„ B-cell Maturation Antigen
๋ฐœํ˜„ ์œ„์น˜ ์ฃผ๋กœ ๋ง์ดˆ ํ˜ˆ์•ก์˜ plasma cell / ๋‹ค๋ฐœ๊ณจ์ˆ˜์ข… ์„ธํฌ
์ •์ƒ์กฐ์ง ๋ฐœํ˜„ ๋งค์šฐ ์ œํ•œ์  → ์ข…์–‘ ์„ ํƒ์„ฑ ์šฐ์ˆ˜
์งˆํ™˜ ์ ์‘์ฆ ๋‹ค๋ฐœ๊ณจ์ˆ˜์ข…(MM)
ํƒ€๊นƒ์œผ๋กœ์„œ ์žฅ์  - Plasma cell ํŠน์ด ๋ฐœํ˜„
- shedding ๋œ soluble BCMA (sBCMA)๋Š” disease burden marker๋กœ๋„ ์‚ฌ์šฉ
- CAR-T, BsAb, ADC ๋“ฑ ๋‹ค์–‘ํ•œ ์ „๋žต ๊ฐ€๋Šฅ
 

๐Ÿ’Š BCMA ํƒ€๊นƒ ์น˜๋ฃŒ์ œ ๋น„๊ต (๊ธฐ์ˆ ๋ณ„)

๊ธฐ์ˆ ์•ฝ๋ฌผํšŒ์‚ฌ๊ตฌ์กฐ / ๋ฉ”์ปค๋‹ˆ์ฆ˜์ ์‘์ฆ์Šน์ธ/์ž„์ƒ
๐Ÿงฌ CAR-T Abecma (ide-cel)
Carvykti (cilta-cel)
BMS/Bluebird
Janssen/Legend
BCMA CAR-T R/R MM โœ… ์Šน์ธ (๋ฏธ๊ตญ, EU, ้Ÿ“)
๐Ÿ’ฅ ADC Blantamab mafodotin GSK BCMA Ab + MMAF (non-cleavable) R/R MM ์Šน์ธ→2022๋…„ ์ž์ง„ ์ฒ ํšŒ (๊ฐ๋ง‰ ๋…์„ฑ)
๐Ÿ”ฅ T-cell engager (BiTE / BsAb) Teclistamab Janssen BCMA × CD3 bispecific (IgG-like) R/R MM โœ… ์Šน์ธ (2022 FDA)
  Elranatamab Pfizer BCMA × CD3 bispecific R/R MM โœ… ์Šน์ธ (2023 FDA)
  REGN5458 / REGN5837 Regeneron BCMA × CD3 (Veloci-Bi) R/R MM Ph2 ์ง„ํ–‰
  AMG 701 Amgen Half-life extended BiTE R/R MM ๊ฐœ๋ฐœ ์ค‘๋‹จ (toxicity)
 

๐Ÿง  ์ž„์ƒ์  ์ฐจ๋ณ„์  ์š”์•ฝ

ํ•ญ๋ชฉCAR-TADCT-cell engager
์ž‘์šฉ ๋ฐฉ์‹ 1ํšŒ ํˆฌ์—ฌ ํ›„ ์ง€์† ๋ฐ˜์‘ ํ•ญ์ฒด๋กœ ์ง์ ‘ ์„ธํฌ ๋…์„ฑ ์œ ๋„ T cell ๋งค๊ฐœ ์ง์ ‘ ์‚ดํ•ด
ํˆฌ์—ฌ ๋ฐฉ์‹ ํ™˜์ž ๋งž์ถคํ˜• ์„ธํฌ ์น˜๋ฃŒ ์ •๋งฅ ์ฃผ์‚ฌ (๊ฐ„ํ—) ๋ฐ˜๋ณต ์ •๋งฅ or ํ”ผํ•˜์ฃผ์‚ฌ
์žฅ์  ๊นŠ์€ ๋ฐ˜์‘, ์žฅ๊ธฐ ์ƒ์กด ํˆฌ์—ฌ ๊ฐ„ํŽธ off-the-shelf ๊ฐ€๋Šฅ์„ฑ, ์ฆ‰์‹œ ํˆฌ์—ฌ
ํ•œ๊ณ„ ์ œ์กฐ ์‹œ๊ฐ„, ๋น„์šฉ, CRS ๊ฐ๋ง‰ ๋…์„ฑ, ๋‚ด์„ฑ CRS, ์‹ ๊ฒฝ ๋…์„ฑ, ๋ฐ˜๋ณต ํˆฌ์—ฌ ํ”ผ๋กœ๊ฐ
 

๐Ÿ“Š ์ฃผ์š” ์ง€ํ‘œ ๋น„๊ต (Teclistamab ๊ธฐ์ค€)

์ง€ํ‘œ์ˆ˜์น˜
ORR (์ „์ฒด๋ฐ˜์‘๋ฅ ) ~63%
CR ์ด์ƒ ๋น„์œจ ~39%
mDOR (๋ฐ˜์‘ ์ง€์†๊ธฐ๊ฐ„) 18.4๊ฐœ์›”
CRS ~72% (Grade ≥3 : 0.6%)
ICANS (์‹ ๊ฒฝ๋…์„ฑ) 3% ๋ฏธ๋งŒ
ํˆฌ์—ฌ ๋ฐฉ์‹ ์ฃผ1ํšŒ ํ”ผํ•˜์ฃผ์‚ฌ (step-up dose ํฌํ•จ)
 

๐Ÿ”ฌ ๊ตญ๋‚ด์™ธ ๊ธฐ์—… ๋™ํ–ฅ

ํšŒ์‚ฌ๊ธฐ์ˆ ๊ฐœ๋ฐœ์ƒํ™ฉ
GC์…€ / ToolGen / ํ๋กœ์…€ BCMA CAR-T ๊ตญ๋‚ด ๊ณต๋™๊ฐœ๋ฐœ ์ง„ํ–‰ ์ค‘
๋ ˆ๊ณ ์ผ๋ฐ”์ด์˜ค ADC (BCMA-ADC) LCB-ADC ํ”Œ๋žซํผ์œผ๋กœ ์ „์ž„์ƒ
์—์ด๋น„์—˜๋ฐ”์ด์˜ค BsAb (ABL503) PD-L1×4-1BB ์ง„ํ–‰ ์ค‘, BCMA๋Š” ์•„๋‹˜
GenScript / WuXi / JW CRO ํ˜•ํƒœ๋กœ CAR-T CDMO ํ™•๋Œ€ BCMA ํฌํ•จ
ํ•œ๋ฏธ์•ฝํ’ˆ (HanAll) BsAb ํ”Œ๋žซํผ ๋ณด์œ  ๋ผ์ด์„ ์Šค ์•„์›ƒ ๊ฐ€๋Šฅ์„ฑ
 

๐Ÿงญ ํˆฌ์ž ๋ฐ ์ „๋žต์  ํฌ์ธํŠธ

  1. Teclistamab/Elranatamab ์„ฑ๊ณต ์ดํ›„ → off-the-shelf TCE์— ๋Œ€ํ•œ ํˆฌ์ž ์ฆ๊ฐ€
  2. BCMA+GPRC5D / BCMA+CD38 ์ด์ค‘ํ•ญ์ฒด ๊ฐœ๋ฐœ ํ™œ๋ฐœ (๋‚ด์„ฑ ๊ทน๋ณต ๋ชฉ์ )
  3. Pre-targeting ์ „๋žต or masking/Cleavable ๊ตฌ์กฐ → CRS ๋‚ฎ์ถ”๊ธฐ ์œ„ํ•œ ์ฐจ์„ธ๋Œ€ ํ”Œ๋žซํผ ์ฃผ๋ชฉ
  4. ๊ตญ๋‚ด ๋ฐ”์ด์˜คํ…: ADC/BsAb ๊ธฐ์ˆ  out-license ํ˜น์€ BCMA + ๋ฉด์—ญ checkpoint ๋ณ‘์šฉ ๊ฐ€๋Šฅ์„ฑ ํƒ์ƒ‰ ํ•„์š”
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