Immunotherapy for Multiple Myeloma, Past, Present, and Future: Monoclonal Antibodies, Vaccines, and Cellular Therapies.
Multiple myeloma is a disorder of terminally differentiated plasma cells, characterized by immune dysfunction, deregulated signaling within the bone marrow stromal compartment, and a microenvironment that fosters immunosuppression. Immunomodulatory techniques, such as allogeneic hematopoietic stem cell transplant (allo-HCT) and donor lymphocyte infusion (DLI), demonstrate long-term disease control via manipulation of the immunologic milieu. However, allo-HCT is associated with numerous toxicities including infectious complications and graft versus host effect and is not suitable for many patients. Novel agents and cellular-based therapies aim to restore the balance of humoral and adaptive immunity without the morbidity of allo-HCT and DLI. In the following review, we will summarize the use of immunomodulatory techniques in multiple myeloma, including monoclonal antibodies, vaccine therapy, checkpoint inhibitors, autologous T cells, and engineered T cells.
Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA. Rkarp@bidmc.harvard.edu.
Rebecca
R
Karp Leaf
Tisch Cancer Institute, Icahn School of Medicine at Mt. Sinai, One Gustave L Levy Place, Box 1079, New York, NY, 10029, USA. hearn.jay.cho@mssm.edu.
Hearn Jay
HJ
Cho
Section of Hematological Malignancies and Bone Marrow Transplantation, Beth Israel Deaconess Medical Center, KS121, Boston, MA, 02215, USA. davigan@bidmc.harvard.edu.
David
D
Avigan
D000911:Antibodies, Monoclonal / Q000378:metabolism*; D064987:Cell- and Tissue-Based Therapy / Q000379:methods*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D007167:Immunotherapy / Q000379:methods; D009101:Multiple Myeloma / Q000628:therapy*; D014184:Transplantation, Homologous / Q000379:methods*
D000911:Antibodies, Monoclonal
Allogeneic transplantation; Cellular immunotherapy; Idiotype vaccine; Monoclonal antibodies; Multiple myeloma; Vaccine therapy