Atanackovic Djordje, Steinbach Mary, Radhakrishnan Sabarinath Venniyil, Luetkens Tim
Multiple Myeloma Program & Cancer Immunology, Hematology and Hematologic Malignancies, University of Utah / Huntsman Cancer Institute , Salt Lake City, UT, USA.
Oncoimmunology. 2016 Aug 5;5(11):e1217374. doi: 10.1080/2162402X.2016.1217374. eCollection 2016.
Recently, the monoclonal antibody daratumumab was approved as a single agent for the treatment of patients with relapsed/refractory Multiple Myeloma (MM). Daratumumab is an antibody targeting surface molecule CD38 on myeloma cells and the agent is already widely being used based on its good tolerability and proven efficacy. We believe, however, that the efficacy of this drug and other anti-CD38 monoclonal antibodies can be further improved by combining it with other types of immunotherapies. Furthermore, surface molecule CD38 can be used as a target for immunotherapies other than just naked monoclonal antibodies. In this report, we review the expression pattern of CD38 among normal tissues and in different types of plasma cell dyscrasias including their progenitor cells, minimal residual disease, and circulating tumor cells. We summarize the physiological role of CD38 as well as its role in the pathophysiology of MM and we present the most recent clinical trials using CD38 as a target. In addition, we highlight possible combination immunotherapies incorporating anti-CD38 monoclonal antibodies and we demonstrate alternative immunotherapeutic approaches targeting the same antigen such as CD38-specific chimeric antigen receptor (CAR) T cells.
最近,单克隆抗体达雷妥尤单抗被批准作为单一药物用于治疗复发/难治性多发性骨髓瘤(MM)患者。达雷妥尤单抗是一种靶向骨髓瘤细胞表面分子CD38的抗体,基于其良好的耐受性和已证实的疗效,该药物已被广泛使用。然而,我们认为,将这种药物与其他类型的免疫疗法联合使用,可以进一步提高其疗效。此外,表面分子CD38不仅可以作为裸单克隆抗体的靶点,还可以作为其他免疫疗法的靶点。在本报告中,我们回顾了CD38在正常组织以及不同类型浆细胞发育异常(包括其祖细胞、微小残留病和循环肿瘤细胞)中的表达模式。我们总结了CD38的生理作用及其在MM病理生理学中的作用,并介绍了以CD38为靶点的最新临床试验。此外,我们重点介绍了可能的联合免疫疗法,包括抗CD38单克隆抗体,并展示了针对同一抗原(如CD38特异性嵌合抗原受体(CAR)T细胞)的替代免疫治疗方法。