双特异性抗体 (BsAb) 是人工工程抗体，可以同时与 T 细胞受体复合物内的 CD3 亚基和肿瘤细胞上的抗原结合，从而激活 T 细胞并杀死肿瘤细胞。针对 BCMA 或 GPRC5D 的双特异性抗体在经过多次治疗的复发/难治性多发性骨髓瘤 (RRMM) 患者中显示出令人印象深刻的临床活性，其中一些药物在第三次（欧洲药品管理局，EMA）或第四次（食品和药物管理局）之后已经获得监管部门的批准。和药物管理局 (FDA) 的治疗方案；针对 FcRH5 的早期临床试验结果也很有希望。总体而言，BsAb 作为单一疗法与超过 60% 的 ORR 相关，CR 率较高，介于 25% 至 50% 之间，且先前接受过中位数 4-6 线治疗的患者的中位 PFS 约为 1 年。主要毒性包括细胞因子释放综合征、血细胞减少、低丙种球蛋白血症和感染；抗 GPRC5D BsAb 也可能发生涉及皮肤、粘膜、头发和指甲的靶向脱瘤不良事件。提高其疗效和改善其耐受性的积极研究仍在进行中，包括联合疗法和在早期治疗线中的应用以及新型药物的开发。更好地理解耐药机制是一项挑战，可能会带来更个性化的方法。

Bispecific antibodies (BsAbs) are artificially engineered antibodies that can bind simultaneously to the CD3 subunit within the T-cell receptor complex and an antigen on tumor cells, leading to T-cell activation and tumor cell killing. BsAbs against BCMA or GPRC5D have shown impressive clinical activity in heavily pretreated patients with relapsed/refractory multiple myeloma (RRMM), with some agents having already received regulatory approval after the third (by the European Medicines Agency, EMA) or fourth (by the Food and Drug Administration, FDA) line of therapy; the results of early-phase clinical trials targeting FcRH5 are also promising. Overall, BsAbs as monotherapy correlated with an ORR that exceeded 60%, with a high CR rate ranging between 25% and 50% and a median PFS of around 1 year among patients with a median of 4-6 prior lines of therapy. The main toxicities include cytokine release syndrome, cytopenias, hypogammaglobulinemia, and infections; on-target off-tumor adverse events involving the skin, mucosa, hair, and nails may also occur with anti-GPRC5D BsAbs. Active research to increase their efficacy and improve their tolerance is still in progress, including combination therapies and application in earlier treatment lines and the development of novel agents. A better understanding of the mechanisms of resistance is a challenge and could lead to more personalized approaches.