{
  "abstract": "T cell engagers (TCEs) have emerged as transformative agents in multiple myeloma, driving a paradigm shift through advances in molecular engineering and clinical application. This review examines these developments across structural design and clinical optimization. Structurally, the field has evolved from IgG-like formats enabling subcutaneous administration toward multi-specific architectures designed to circumvent antigen escape and enhance tumor selectivity. Clinically, strategies have been refined by early TCE integration to leverage preserved immune fitness, step-up dosing to mitigate cytokine release syndrome, and combinations with gamma-secretase inhibitors or immunomodulatory drugs to overcome resistance. However, key limitations persist: antigen loss and lineage plasticity; on-target/off-tumor depletion of normal plasma cells with hypogammaglobulinemia and infection; T-cell exhaustion under continuous exposure; and the absence of predictive biomarkers for response, toxicity, and sequencing. Future efforts should prioritize conditional or logic-gated formats that decouple potency from systemic exposure, target rotation to preempt escape, biomarker-driven selection with minimal residual disease-guided duration, and home-based subcutaneous delivery. Integrating bioengineering innovation with optimized clinical protocols while confronting these constraints will be essential for TCEs to deliver durable remissions and advance the prospect of a functional cure for MM.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China.",
    "Key Laboratory of Biological Targeted Therapy (Huazhong University of Science and Technology), Ministry of Education, Wuhan, Hubei, People's Republic of China."
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Linyu Cai",
      "orcid": "0009-0003-1186-1818"
    },
    {
      "affs": [
        0
      ],
      "name": "Yuxuan Ding"
    },
    {
      "affs": [
        0
      ],
      "name": "Jinhua Wang"
    },
    {
      "affs": [
        0
      ],
      "name": "Lixin Quan"
    },
    {
      "affs": [
        0
      ],
      "name": "Qun Li"
    },
    {
      "affs": [
        0
      ],
      "name": "Guangqi Wang"
    },
    {
      "affs": [
        0
      ],
      "name": "Chi Ma"
    },
    {
      "affs": [
        0
      ],
      "name": "Chunyan Sun"
    },
    {
      "affs": [
        1
      ],
      "name": "Yu Hu"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/c7c66mzhvpp2a.bib",
  "cited_by": 0,
  "doi": "10.2147/dddt.s638795",
  "fulltext_url": "https://europepmc.org/articles/PMC13693796",
  "id": "c7c66mzhvpp2a",
  "issns": [
    "1177-8881"
  ],
  "landing_url": "https://europepmc.org/article/MED/42921550",
  "language": "eng",
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2720|Multiple Myeloma Research and Treatments"
    ]
  ],
  "openalex": "W7222904315",
  "pdf_url": "https://europepmc.org/articles/PMC13693796?pdf=render",
  "pmcid": "PMC13693796",
  "pmid": "42921550",
  "published": "2026-10-19",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/c7c66mzhvpp2a.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:33Z",
      "native_id": "MED:42921550",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42921550"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2720|Multiple Myeloma Research and Treatments",
      "subfield": "general"
    }
  ],
  "title": "Advancing T Cell Engagers in Multiple Myeloma: Structural Design and Clinical Optimization to Address Current Limitations.",
  "title_text": "Advancing T Cell Engagers in Multiple Myeloma: Structural Design and Clinical Optimization to Address Current Limitations.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:33Z",
  "url": "https://research.draconitic.com/paper/c7c66mzhvpp2a",
  "venue": "Drug design, development and therapy",
  "versions": []
}