Alkharabsheh Omar, Trisel Zachary, Badami Sunil, Aljama Mohammed A, Sidiqi M Hasib
Mitchell Cancer Institute, University of South Alabama, Mobile, AL 36604, USA.
Department of Oncology, Division of Malignant Hematology, McMaster University, Hamilton, ON L8V 5C2, Canada.
Cancers (Basel). 2021 Dec 27;14(1):113. doi: 10.3390/cancers14010113.
Immune dysregulation and alteration of the bone marrow microenvironment allowing plasma cells to escape immune surveillance are well-known factors associated with the proliferation of clonal plasma cells and development of multiple myeloma (MM). Whilst immunotherapeutic approaches are now commonplace in a wide spectrum of malignancies, this aberration of myeloma development gives rise to the biological rationale for the use of immune checkpoint inhibitors (ICIs) in MM. However, the initial experience with these agents has been challenging with limited single agent efficacy, significant toxicity, and side effects. Herein, we review the biological and immunological aspects of MM and ICIs. We discuss the basic biology of immune checkpoint inhibitors, mechanisms of resistance, and drug failure patterns, review the published clinical trial data for ICIs in MM, and look towards the future of ICIs for MM treatment.
免疫失调以及骨髓微环境的改变，使得浆细胞能够逃脱免疫监视，这些都是与克隆性浆细胞增殖和多发性骨髓瘤（MM）发展相关的已知因素。虽然免疫治疗方法目前在多种恶性肿瘤中已很常见，但骨髓瘤发展的这种异常情况为在MM中使用免疫检查点抑制剂（ICI）提供了生物学依据。然而，这些药物的初步使用经验颇具挑战性，单药疗效有限，毒性和副作用显著。在此，我们综述MM和ICI的生物学及免疫学方面。我们讨论免疫检查点抑制剂的基本生物学特性、耐药机制和药物失效模式，回顾已发表的MM中ICI的临床试验数据，并展望ICI用于MM治疗的未来。
