{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T23:00:22Z","timestamp":1793833222572,"version":"4.6.1"},"reference-count":25,"publisher":"American Society of Hematology","issue":"4","license":[{"start":{"date-parts":[[2024,5,10]],"date-time":"2024-05-10T00:00:00Z","timestamp":1715299200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,7,25]]},"abstract":"<jats:sec>\n                  <jats:title>Abstract<\/jats:title>\n                  <jats:p>B-cell maturation antigen (BCMA)\u2013targeting therapeutics have dramatically improved outcomes in relapsed\/refractory multiple myeloma (RRMM). However, whether the mechanisms of resistance between these therapies are shared and how the identification of such mechanisms before therapy initiation could refine clinical decision-making remains undefined. We analyzed outcomes for 72 RRMM patients treated with teclistamab, a CD3\u00a0\u00d7 BCMA bispecific antibody, 42% (30\/72) of whom had prior BCMA-directed therapy exposure. Malignant plasma cell BCMA expression was present in all BCMA therapy\u2013na\u00efve patients. Prior therapy\u2013mediated loss of plasma cell BCMA expression before teclistamab treatment, measured by immunohistochemistry, was observed in 3 patients, none of whom responded to teclistamab, and 1 of whom also did not respond to ciltacabtagene autoleucel. Whole exome sequencing of tumor DNA from 1 patient revealed biallelic loss of TNFRSF17 following treatment with belantamab mafodotin. Low-to-undetectable peripheral blood soluble BCMA levels correlated with the absence of BCMA expression by bone marrow plasma cells. Thus, although rare, loss of BCMA expression following TNFRSF17 gene deletions can occur following any BCMA-directed therapy and prevents response to subsequent anti-BCMA\u2013directed treatments, underscoring the importance of verifying the presence of a target antigen.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1182\/blood.2023023557","type":"journal-article","created":{"date-parts":[[2024,5,10]],"date-time":"2024-05-10T18:01:12Z","timestamp":1715364072000},"page":"402-407","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":71,"title":["Antigen escape as a shared mechanism of resistance to BCMA-directed therapies in multiple myeloma"],"prefix":"10.1182","volume":"144","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2945-9320","authenticated-orcid":false,"given":"Ross S.","family":"Firestone","sequence":"first","affiliation":[{"name":"1Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New 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