Monoclonal Antibodies in Multiple Myeloma: A New Wave of the Future

Publication date: Available online 27 June 2017 Source:Clinical Lymphoma Myeloma and Leukemia Author(s): Daniel W. Sherbenou, Tomer M. Mark, Peter Forsberg In 2015, two monoclonal antibodies were approved for the treatment of relapsed or refractory multiple myeloma (RRMM), elotuzumab and daratumumab. Elotuzumab is a monoclonal IgG-κ antibody directed against SLAMF7, a cell surface receptor involved in natural killer cell activation. Daratumumab is a monoclonal IgG-κ antibody that binds to CD38, a transmembrane protein found on the surface of myeloma cells responsible for cellular adhesion and ectoenzymatic activity. Both elotuzumab and daratumumab act through recruitment of the immune system to enhance cellular cytotoxicity directed against myeloma cells. Elotuzumab requires lenalidomide and dexamethasone in combination to enhance progression free survival in patients with RRMM, while daratumumab has both single agent and combination activity with either lenalidomide or the proteasome inhibitor bortezomib in RRMM. The adverse effect profile of both agents mainly consist of allergic-type infusion reactions. Other considerations for monoclonal antibody use in the treatment of myeloma include the potential for interference on serum protein electrophoresis testing, as well as cross reactivity of daratumumab with CD38 present on red blood cells. In this manuscript, we discuss the clinical development of daratumumab and elotuzumab, as well as newer immunologic approaches to ...
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research