Review on future therapies in Multiple Myeloma

The treatment of Multiple Myeloma (MM) is currently being redefined by humoral and cellular immunotherapies. For decades, there was limited believe in immune-based anti-MM therapy due to the moderate graft-versus-myeloma effect of allogeneic stem cell transplantation.

Today, monoclonal antibodies are the new backbone of anti-MM therapy, and T-cell therapies targeting BCMA are emerging as the most potent single agents for MM treatment. The authors present their assessment and vision for MM immunotherapy in the short- and midterm future.

There is a rich pipeline of novel CAR T-cell products, bsAbs, and trispecific antibodies that target alternative antigens including e.g. SLAMF7, CD44v6 and GPRC5D, as well as multi-specific CAR T-cells. In another approach, NK cells are used as effector cells and CAR-modified NK cells as well as bispecific killer cell engager (BiKE) targeting MM antigens showed encouraging results in preclinical studies.

Significant efforts are undertaken to simplify the manufacturing and logistics around CAR Tcell therapy involving virus-free gene-transfer, automated point-of-care production and allogeneic cell products. With these developments, the prospects are good that the role of immunotherapy in MM will be manifested and the ideal of a chemo-free free, yet curative treatment for the majority of MM patients can become ‘real’ within the next decade.

 

The abstract of the review can be found here (Blood).