Novel Cell and Immune Engagers in Optimizing Tumor- Specific Immunity Post-Autologous Transplantation in Multiple Myeloma

Murali Janakiram; Nivedita Arora; Veronika Bachanova; Jeffrey S Miller

doi:10.1016/j.jtct.2021.10.001

Novel Cell and Immune Engagers in Optimizing Tumor- Specific Immunity Post-Autologous Transplantation in Multiple Myeloma

Transplant Cell Ther. 2022 Feb;28(2):61-69. doi: 10.1016/j.jtct.2021.10.001. Epub 2021 Oct 8.

Authors

Murali Janakiram¹, Nivedita Arora², Veronika Bachanova², Jeffrey S Miller²

Affiliations

¹ Blood and Marrow Transplant Program, Department of Medicine, University of Minnesota, Minneapolis, Minnesota; Division of Hematology, Oncology, and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, Minnesota. Electronic address: mjanakiram@coh.org.
² Blood and Marrow Transplant Program, Department of Medicine, University of Minnesota, Minneapolis, Minnesota; Division of Hematology, Oncology, and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, Minnesota.

PMID: 34634499
DOI: 10.1016/j.jtct.2021.10.001

Abstract

Autologous stem cell transplantation (ASCT) is an important component of treatment of multiple myeloma (MM). The post-ASCT setting offers a unique opportunity to increase myeloma specific immunity through enhancement of T and NK cell responses. The vast array of therapeutics being developed for MM, including cell-based therapies, dendritic vaccines, bispecific antibodies, and IL-15 agonists, provide the opportunity to increase tumor-specific immunity. Maintenance therapies, including immunomodulatory drugs, proteasome inhibitors, and daratumumab, exhibit a significant anti-myeloma response by modulating the immune system. Lenalidomide promotes an antitumoral immune microenvironment, whereas daratumumab can potentially cause NK cell fratricide. Thus, understanding the effects of commonly used maintenance drugs on the restoration of tumor specific immunity is important. In this review, we look at current and emerging therapeutics and their integration post-ASCT in the context of immune reconstitution to improve clinical responses in patients with MM. © 2021 American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc.

Keywords: Bispecific antibodies; CARNK; CART; Immune reconstitution; Multiple myeloma.

Publication types

Review

MeSH terms

Hematopoietic Stem Cell Transplantation*
Humans
Lenalidomide / therapeutic use
Multiple Myeloma* / therapy
Proteasome Inhibitors / therapeutic use
Transplantation, Autologous
Tumor Microenvironment

Substances

Proteasome Inhibitors
Lenalidomide

Grants and funding

P01 CA065493/CA/NCI NIH HHS/United States