Sociedad Argentina de Hematología

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Revista Argentina de Hematología


Volumen:    21    # Number : 1

Publication Date :    Enero - Abril    Year:    2017


Monoclonal antibodies in multiple myeloma

Authors: Ocio, EM; Mateos, MV

Abstract: The appearance of the MoAb represented a revolution in cancer therapy that has already been transferred to MM. In this work the main mechanisms of action of the MoAbs are reviewed, both in their effects on the tumor cell (CDC, ADCC or ADCP), and on the immune system; the clinical data currently available in MM are also reviewed. The first MoAb to be approved for the treatment of MM was elotuzumab, an anti-SLAMF7 MoAb, but in combination with lenalidomide and dexamethasone for patients who had received between 1-3 previous treatment lines because elotuzumab does not work as single agent. Subsequently, the anti-CD38 MoAb daratumumab was approved as monotherapy for the treatment of patients previously exposed to proteasome inhibitors and IMiDs and refractory to the last line, based on the efficacy demonstrated in two studies in highly pretreated and refractory patients, as single agent. More recently, this drug has been evaluated in combination with lenalidomide and dexamethasone and with bortezomib and dexamethasone in randomized trials in which the addition of daratumumab demonstrated a better response rate and progression free survival than the standard without the MoAb, which led to the approval of both combinations for relapsed patients by the FDA. Other anti-CD38 MoAbs, as well as other antibodies directed against the PD1 immune checkpoint, are currently being evaluated, with promising preliminary results. In conclusion, these treatments, which are already available, may increasingly be incorporated into the different therapeutic algorithms, representing a new concept in the treatment of MM.

Key words: Daratumumab, Elotuzumab, Immunotherapy, Multiple myeloma, Monoclonal antibodies.

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