BB2121 CAR-T(Abecma、Idecabtagene Vicleucel、ide-cel)

BB2121 CAR-T(Abecma、Idecabtagene Vicleucel、ide-cel)

BB2121 CAR-T, now known as Abecma, Idecabtagene Vicleucel, or ide-cel.

Bluebird bio initially designed and compared four second-generation anti-BCMA CARs encoded by lentiviral vectors. The authors then explored the structure of bb2121 in more detail, as these CAR-transduced T cells exhibited potent in vitro anti-myeloma cell line activity and in vivo anti-human myeloma activity in mouse models. BB2121 is composed of an anti-BCMA single-chain variable fragment (scFv) fused to a CD8 hinge region, a CD137 (4-1BB) costimulatory domain, and a CD3ζ signaling domain (Figure 1). The authors transduced the bb2121 structure into human autologous T cells, redirecting them to kill myeloma cells, resulting in the CAR-T cell product idecabtagene vicleucel (ide-cel).

Idecabtagene vicleucel (Abecma, ide-cel) is the first FDA-approved B-cell maturation antigen (BCMA)-directed chimeric antigen receptor (CAR) T-cell immunotherapy. BCMA is a crucial B-cell biomarker widely expressed on the surface of multiple myeloma (MM) cells. Abecma can recognize and bind to the BCMA protein on MM cancer cells, leading to the death of BCMA-expressing cancer cells.

On March 26, 2021, Bristol Myers Squibb and bluebird bio jointly announced that the FDA had approved Abecma (idecabtagene vicleucel, ide-cel) for the treatment of adult patients with relapsed or refractory multiple myeloma after four or more prior lines of therapy, including an immunomodulatory agent, a proteasome inhibitor, and an anti-CD38 monoclonal antibody.

On April 4, 2024, the FDA approved Abecma (idecabtagene vicleucel, ide-cel) for the treatment of multiple myeloma patients who have received at least two prior therapies. Idecabtagene vicleucel is another BCMA-targeted CAR T-cell therapy. This treatment can be used in patients previously treated with an anti-CD38 antibody, a proteasome inhibitor, and an immunomodulatory agent. The FDA granted this approval based on the results of the phase 3 KarMMa-3 clinical trial [7]. In this trial, 254 patients received idecabtagene vicleucel, and 132 patients received standard treatment regimens. The standard regimens given to patients included DPd, elotuzumab, pomalidomide, and dexamethasone (EPd), daratumumab, bortezomib, and dexamethasone (DVd), carfilzomib and dexamethasone (Kd), or ixazomib, lenalidomide, and dexamethasone (IRd).