Multiple myeloma (MM) is at the forefront of immuno-oncology research, with a vast array of novel immunotherapies currently under investigation. Typical targets include plasma cell antigens, such as CD38 and SLAMF7, and immune checkpoints like PD-1, while immunotherapies targeting BCMA are showing promise.
Antibody-based approaches are reshaping the standard of care for MM. The addition of monoclonal antibodies to standard triplet regimens is proving efficacious; the addition of daratumumab to VMP has shown to be superior to VMP alone in the newly diagnosed setting1,2, while the addition of isatuximab, another anti-CD38 antibody, is looking promising in the frontline and relapsed/refractory settings3-5. Antibody-drug conjugates6-8 and bispecifics9,10 are also displaying potential. Other developments in this field include novel formulations, such as subcutaneous daratumumab, yielding improved convenience and safety11. Checkpoint inhibitor antibodies are an exciting therapy for MM, which are being tested in the frontline and relapsed/refractory settings. Pembrolizumab has produced positive results in both the upfront and relapsed settings12-14, while nivolumab, durvalumab and atezolizumab are also in trials15-17.
Another area of interest in immunotherapy for MM is CAR T-cell therapy. Promising agents include a SLAMF7-targeting CAR T-cell therapy18, and bb212119,20, which targets BCMA, and which many hope will follow in the steps of other CAR T-cell agents that have been approved for the treatment of ALL and DLBCL. NK-cell therapy21,22 and personalized vaccines23-25 are also being investigated, which while less established currently, are a promising area.
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