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Why Immunotherapy Fails in Multiple Myeloma

Amyloidosis and Multiple Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, 08036 Barcelona, Spain
Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
Author to whom correspondence should be addressed.
These authors contributed equally to this manuscript.
These authors share senior authorship.
Received: 15 November 2020 / Revised: 15 December 2020 / Accepted: 18 December 2020 / Published: 22 December 2020
Multiple myeloma remains an incurable disease despite great advances in its therapeutic landscape. Increasing evidence supports the belief that immune dysfunction plays an important role in the disease pathogenesis, progression, and drug resistance. Recent efforts have focused on harnessing the immune system to exert anti-myeloma effects with encouraging outcomes. First-in-class anti-CD38 monoclonal antibody, daratumumab, now forms part of standard treatment regimens in relapsed and refractory settings and is shifting to front-line treatments. However, a non-negligible number of patients will progress and be triple refractory from the first line of treatment. Antibody-drug conjugates, bispecific antibodies, and chimeric antigen receptors (CAR) are being developed in a heavily pretreated setting with outstanding results. Belantamab mafodotin-blmf has already received approval and other anti-B-cell maturation antigen (BCMA) therapies (CARs and bispecific antibodies are expected to be integrated in therapeutic options against myeloma soon. Nonetheless, immunotherapy faces different challenges in terms of efficacy and safety, and manufacturing and economic drawbacks associated with such a line of therapy pose additional obstacles to broadening its use. In this review, we described the most important clinical data on immunotherapeutic agents, delineated the limitations that lie in immunotherapy, and provided potential insights to overcome such issues. View Full-Text
Keywords: multiple myeloma; immunotherapy; daratumumab; BCMA; bi-specific T cell engagers; chimeric antigen receptor; relapse; cytokine-release syndrome multiple myeloma; immunotherapy; daratumumab; BCMA; bi-specific T cell engagers; chimeric antigen receptor; relapse; cytokine-release syndrome
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MDPI and ACS Style

Rodríguez-Lobato, L.G.; Oliver-Caldés, A.; Moreno, D.F.; Fernández de Larrea, C.; Bladé, J. Why Immunotherapy Fails in Multiple Myeloma. Hemato 2021, 2, 1-42.

AMA Style

Rodríguez-Lobato LG, Oliver-Caldés A, Moreno DF, Fernández de Larrea C, Bladé J. Why Immunotherapy Fails in Multiple Myeloma. Hemato. 2021; 2(1):1-42.

Chicago/Turabian Style

Rodríguez-Lobato, Luis G., Aina Oliver-Caldés, David F. Moreno, Carlos Fernández de Larrea, and Joan Bladé. 2021. "Why Immunotherapy Fails in Multiple Myeloma" Hemato 2, no. 1: 1-42.

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