Emerging immunotherapies in multiple myeloma
BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m3176 (Published 21 September 2020) Cite this as: BMJ 2020;370:m3176
- 1Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, 530 East 74th Street, New York, NY 10021, USA
- Correspondence to: U A Shah shahu{at}mskcc.org
ABSTRACT
Despite considerable advances in treatment approaches in the past two decades, multiple myeloma remains an incurable disease. Treatments for myeloma continue to evolve with many emerging immunotherapies. The first immunotherapy used to treat hematologic cancers, including multiple myeloma, was an allogeneic stem cell transplant. In the mid-2000s, immunomodulatory drugs thalidomide, lenalidomide, and subsequently pomalidomide were proven to be effective in multiple myeloma and substantially improved survival. The next wave of immunotherapies for multiple myeloma included the monoclonal antibodies daratumumab and elotuzumab, which were approved by the Food and Drug Administration in 2015. Subsequently, a variety of immunotherapies have been developed for multiple myeloma, including chimeric antigen receptor T cells, bispecific antibodies, antibody drug conjugates, and checkpoint inhibitors. Many of these emerging treatments target the B cell maturation antigen, which is expressed on plasma cells, although several other novel receptors are also being studied. This review summarizes the evidence of these various immunotherapies, their mechanism of action, and data from clinical trials regarding the treatments’ safety and efficacy.
Footnotes
Series explanation: State of the Art Reviews are commissioned on the basis of their relevance to academics and specialists in the US and internationally. For this reason they are written predominantly by US authors
Contributors: Both authors were involved in the conceptualization, writing, and editing of the manuscript. UAS is the guarantor.
Funding: Funding support for this publication was provided by the Memorial Sloan Kettering Core Grant (P30 CA008748) and Parker Institute for Cancer Immunotherapy.
Competing interests: We have read and understood BMJ policy on declaration of interests and declare the following competing interests: UAS has received research funding from Celgene/Bristol Myers Squibb (BMS) and Parker Institute for Cancer Immunotherapy to her institution and honorariums for continuing medical education activity from the Physicians Education Resource. SM has received research funding from the National Cancer Institute R21CA235154, Janssen, Juno/Celgene/BMS, Takeda, Allogene to his institution and honorariums for continuing medical education activity from the Physicians Education Resource.
Provenance and peer review: Commissioned; externally peer reviewed.
Patient involvement: No patients were asked for input in the creation of this article.
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