Abstract
Simple SummaryMonoclonal antibodies represent a major therapeutic progress in multiple myeloma during the last decade. The use of antibodies as well as antibody drug conjugates has changed the treatment landscape rapidly. The intent of this paper is to summarize the current major results of monoclonal antibody treatments in multiple myeloma.Multiple myeloma is the second most common hematologic malignancy. Current treatment strategies are mainly based on immunomodulatory drugs, proteasome inhibitors or combination of both. Novel agents added to these backbone treatments represent a promising strategy in treatment of newly diagnosed as well as relapsed and refractory multiple myeloma patients. In this respect, the incorporation of monoclonal antibodies into standard-of-care regimens markedly improved prognosis of myeloma patients during the last years. More specifically, monoclonal anti-CD38 antibodies, daratumumab and isatuximab, have been implemented into treatment strategies from first-line treatment to refractory disease. In addition, the monoclonal anti-SLAM-F7 antibody elotuzumab in combination with immunomodulatory drugs has improved the clinical outcomes of patients with relapsed/refractory disease. Belantamab mafodotin is the first approved antibody drug conjugate directed against B cell maturation antigen and is currently used as a monotherapy for patients with advanced disease. This review focuses on clinical efficacy and safety of monoclonal antibodies as well as antibody drug conjugates in multiple myeloma.
Highlights
Due to the COVID-19 pandemic, we adopted this strategy and observed no serious reactions during the second and subsequent doses. Another approach may be an earlier switch to less frequent daratumumab or isatuximab administrations, if this is feasible in terms of disease control, as is suggested in European Myeloma Network recommendations [64]
Therapeutic strategies incorporating monoclonal antibodies (MoAb) have especially increased depth of response including many patients achieving minimal residual disease (MRD) negative, which translates into prolonged progression free survival (PFS) and overall survival (OS)
The MAMMOTH study described the outcomes of triple-refractory patients
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. After introduction of proteasome inhibitors and immunomodulating agents, the landscape of treatment is still rapidly evolving, and monoclonal antibodies (MoAb) have become an integral part of the myeloma therapeutic approach. The molecule is expressed and distributed on plasma cells and on other myeloid and lymphoid cells [3]. Other immune effector cells show high expression of CD38 including regulatory. A decrease in plasmacytoid densdritic cells, which support MM cell growth and survival, may represent another potent immune effect of CD38 antibodies [5,6]. CD38 works as an enzyme (ectoenzyme) at it can serve as a receptor triggering proliferation signals [7] As an enzyme, it is involved in the catabolism of nicotinamide adenine dinucleotide (NAD+) and nicotinamide adenine dinucleotide phosphate (NADP). CD38 regulates the migration of dendritic cell precursors from the blood to peripheral sites [11]
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