China Multiple Myeloma Active Clinical Trials Landscape

Chimeric Antigen Receptor T-cell (CAR-T) therapy genetically engineers patient T cells to target myeloma antigens such as BCMA and GPRC5D, delivering deep and durable responses in relapsed/refractory myeloma.

Bispecific antibodies redirect T cells to attack myeloma cells by concurrently binding CD3 and tumor surface targets (BCMA, GPRC5D, FcRH5) as off-the-shelf immunotherapies.

Monoclonal antibodies bind a single antigen on the myeloma cell surface — CD38 being the dominant target in China — and eliminate tumour cells through antibody-dependent cytotoxicity and complement activation. They are a common backbone in both frontline and relapsed regimens.

Oral small-molecule agents span CELMoD degraders, BCL-2 inhibitors and HDAC inhibitors. Their oral route suits long-term administration, and they are typically combined with antibodies or immunomodulators to switch mechanism after resistance.

B-cell maturation antigen (BCMA) is highly expressed on malignant plasma cells with limited expression in normal tissue, making it the most established therapeutic target in multiple myeloma. It is pursued through CAR-T, bispecific antibodies and antibody-drug conjugates.

GPRC5D is an orphan receptor expressed on malignant plasma cells independently of BCMA. Because the two do not share an expression pathway, GPRC5D-directed agents are frequently explored for patients who relapse after BCMA-directed therapy or lose target antigen expression.