Monoclonal antibodies - A new era in the treatment of multiple myeloma

Blood Rev. 2016 Mar;30(2):101-10. doi: 10.1016/j.blre.2015.08.004. Epub 2015 Aug 24.

Abstract

Monoclonal antibodies (mAbs) are currently the most investigated therapeutic compounds in oncology, but there is no monoclonal antibody approved in the treatment of multiple myeloma (MM). Nevertheless several really promising molecules are under investigation in phase III clinical trials. Dominantly daratumumab (anti-CD38) and elotuzumab (anti-CS1) showed extraordinary effectiveness in phase I/II trials. The toxicity was acceptable which is important for their addition to standard anti-myeloma agents like proteasome inhibitors or immunomodulatory drugs. Monoclonal antibodies such as denosumab (anti-RANKL) or BHQ880 (anti-DKK-1) are investigated also in the management of myeloma bone disease. This review is focused on the most promising mAbs, their mechanisms of action and the rationale of use. Practically all available results have been described. If the ongoing trials confirm the efficacy and safety of mAbs, they would become an important part of MM treatment that would be translated in the further improvement of therapeutic outcomes.

Keywords: BHQ880; Bone disease; Daratumumab; Denosumab; Elotuzumab; Lorvotuzumab; Monoclonal antibodies; Multiple myeloma; Pembrolizumab; Siltuximab.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antibodies, Monoclonal / therapeutic use*
  • Antineoplastic Agents / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Bone Diseases / drug therapy
  • Bone Diseases / etiology
  • Clinical Trials as Topic
  • Humans
  • Molecular Targeted Therapy
  • Multiple Myeloma / complications
  • Multiple Myeloma / drug therapy*
  • Multiple Myeloma / mortality
  • Multiple Myeloma / pathology
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal
  • Antineoplastic Agents