Why Immunotherapy Fails in Multiple Myeloma

被引:6
|
作者
Rodriguez-Lobato, Luis Gerardo [1 ,2 ]
Oliver-Caldes, Aina [1 ,2 ]
Moreno, David F. [1 ,2 ]
de Larrea, Carlos Fernandez [1 ,2 ]
Blade, Joan [1 ,2 ]
机构
[1] Hosp Clin Barcelona, Dept Hematol, Amyloidosis & Multiple Myeloma Unit, Barcelona 08036, Spain
[2] Inst Invest Biomed August Pi & Sunyer IDIBAPS, Barcelona 08036, Spain
来源
HEMATO | 2021年 / 2卷 / 01期
基金
欧盟地平线“2020”;
关键词
multiple myeloma; immunotherapy; daratumumab; BCMA; bi-specific T cell engagers; chimeric antigen receptor; relapse; cytokine-release syndrome; CHIMERIC-ANTIGEN-RECEPTOR; CAR-T-CELLS; IMMUNOSUPPRESSIVE TUMOR MICROENVIRONMENT; FIBROBLAST ACTIVATION PROTEIN; MARROW STROMAL CELLS; B-CELL; ANTITUMOR-ACTIVITY; MATURATION ANTIGEN; OPEN-LABEL; CANCER-IMMUNOTHERAPY;
D O I
10.3390/hemato2010001
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Multiple myeloma remains an incurable disease despite great advances in its therapeutic landscape. Increasing evidence supports the belief that immune dysfunction plays an important role in the disease pathogenesis, progression, and drug resistance. Recent efforts have focused on harnessing the immune system to exert anti-myeloma effects with encouraging outcomes. First-in-class anti-CD38 monoclonal antibody, daratumumab, now forms part of standard treatment regimens in relapsed and refractory settings and is shifting to front-line treatments. However, a non-negligible number of patients will progress and be triple refractory from the first line of treatment. Antibody-drug conjugates, bispecific antibodies, and chimeric antigen receptors (CAR) are being developed in a heavily pretreated setting with outstanding results. Belantamab mafodotin-blmf has already received approval and other anti-B-cell maturation antigen (BCMA) therapies (CARs and bispecific antibodies are expected to be integrated in therapeutic options against myeloma soon. Nonetheless, immunotherapy faces different challenges in terms of efficacy and safety, and manufacturing and economic drawbacks associated with such a line of therapy pose additional obstacles to broadening its use. In this review, we described the most important clinical data on immunotherapeutic agents, delineated the limitations that lie in immunotherapy, and provided potential insights to overcome such issues.
引用
收藏
页码:1 / 42
页数:42
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