Exploiting the Immune System to Treat Multiple Myeloma: from Transplantation to Novel Treatment Approaches

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About this Research Topic

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Background

Autologous stem cell transplantation and novel agents such as proteasome inhibitors and immunomodulatory drugs have dramatically improved survival of multiple myeloma (MM) patients. More recently, monoclonal antibodies directed towards plasma cell surface antigens (CD38 and SLAMF7) have been demonstrated to be highly effective and very well tolerated. Combinational therapies that include the use of monoclonal antibodies are already a standard of care in the relapse setting, and they are now moving towards application in patients with newly diagnosed multiple myeloma. The mechanisms of therapeutic resistance as well as the efficacy of re-treatment with monoclonal antibodies in MM patients that have been previously treated, or are refractory to these agents, remain poorly understood. Therefore, novel approaches and strategies to treat this incurable disease, are essential.

Novel strategies towards developing more effective treatment of MM includes incorporating risk and minimal residual disease evaluation when assessing the therapeutic approach to take. In addition, studies have started to address the potential of using upfront and rescue transplantation as a treatment option for MM patients with aggressive disease. New immunologic approaches include bi-specific antibodies and antibody drug-conjugates (such as AMG420 and GSK2857916). Cell therapy, in the past mainly represented by allogeneic stem cell transplantation, can also be beneficial for patients with MM. For example, recently, several clinical trials have explored the use of chimeric antigen receptor (CAR)-T cells directed against B-cell maturation antigen in the treatment of MM patients. Results are encouraging, even if preliminary, with reports including MRD negativity even in heavily pre-treated patients.

This Research Topic aims to provide a comprehensive overview of the current immunotherapeutic strategies for multiple myeloma (i) in the newly diagnosed setting, (ii) in the context of transplant as well as non-transplant eligible patients, and (iii) in the relapse setting. Furthermore, it aims to provide an overview of the more novel immunotherapies other than anti-CD38 and anti-CS1 monoclonal antibodies (such as cell therapies, antibody drug conjugates and bi-specific antibodies) that are currently under evaluation in the relapse setting. We welcome the submission of Review, Mini-Review and Original Research articles that cover, but are not limited, to the following topics:

1. Treatment strategies for newly diagnosed transplant eligible and non-eligible patients with a focus on current and potential future treatment approaches, including MRD and risk adaptive strategies.

2. MRD evaluation and immune profiling in the context of novel immunotherapies.

3. Role of bi-specific antibodies and antibody-drug conjugates in the treatment of multiple myeloma.

4. Clinical updates on the role of auto-transplant and allotransplant in newly diagnosed and relapsed MM patients.

5. Cell therapy for the treatment of relapsed refractory MM patients.

6. Role of novel immunotherapeutic approaches in specific populations (Frail patients, patients with renal failure and patients with rare plasma cell dyscrasias).

7. Role of vaccines for the treatment of multiple myeloma.

8. State of the Immune system in MM patient, newly diagnosed and relapse setting.

9. Potential new targets and approaches to immune therapies with available preclinical data.

Research Topic Research topic image

Keywords: Immunotherapy, Multiple myeloma, transplantation, CAR T-cells, monoclonal antibodies other than anti-CD38 and SLAMF7, antibody drug conjugates, bispecific antibodies, vaccines

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