Division of Hematology and Bone Marrow Transplant, University of Calgary, Alberta, Canada.
Southern Alberta, Cancer Research Institute (SACRI), Calgary, Alberta, Canada.
Clin Cancer Res. 2016 Dec 15;22(24):5959-5965. doi: 10.1158/1078-0432.CCR-16-0184. Epub 2016 Oct 19.
Multiple myeloma is a B-cell malignancy characterized by proliferation of monoclonal plasma cells in the bone marrow. Although new therapeutic options introduced in recent years have resulted in improved survival outcomes, multiple myeloma remains incurable for a large number of patients, and new treatment options are urgently needed. Over the last 5 years, there has been a renewed interest in the clinical potential of immunotherapy for the treatment of multiple myeloma. Clinical progression of myeloma is known to be associated with progressive immune dysregulation and loss of immune surveillance that contribute to disease progression in association with progressive genetic complexity, rendering signaling-based treatments less effective. A variety of strategies to reverse the multiple myeloma-induced immunosuppression has been developed either in the form of immunomodulatory drugs, checkpoint inhibitors, mAbs, engineered T cells, and vaccines. They have shown encouraging results in patients with relapsed refractory multiple myeloma and hold great promise in further improving patient outcomes in multiple myeloma. This review will summarize the major approaches in multiple myeloma immunotherapies and discuss the mechanisms of action and clinical activity of these strategies. Clin Cancer Res; 22(24); 5959-65. ©2016 AACR.
多发性骨髓瘤是一种 B 细胞恶性肿瘤，其特征是骨髓中单克隆浆细胞的增殖。尽管近年来引入的新治疗选择导致了生存结果的改善，但仍有大量患者无法治愈多发性骨髓瘤，因此迫切需要新的治疗选择。在过去的 5 年中，免疫疗法在多发性骨髓瘤治疗中的临床潜力重新引起了人们的兴趣。众所周知，骨髓瘤的临床进展与进行性免疫失调和免疫监视丧失有关，这与疾病进展相关，与进行性遗传复杂性有关，使得基于信号的治疗效果降低。已经开发了多种逆转多发性骨髓瘤诱导的免疫抑制的策略，形式包括免疫调节药物、检查点抑制剂、单抗、工程 T 细胞和疫苗。它们在复发性难治性多发性骨髓瘤患者中显示出令人鼓舞的结果，并有望进一步改善多发性骨髓瘤患者的预后。这篇综述将总结多发性骨髓瘤免疫疗法的主要方法，并讨论这些策略的作用机制和临床活性。临床癌症研究; 22(24); 5959-65. ©2016 AACR.
