Antibody-Based Treatment Approaches in Multiple Myeloma

Abstract

Purpose of review: The field of multiple myeloma treatment has entered a new era with antibody-based approaches in clinical practice. In this review, we focus on the clinical approaches of utilizing antibody-based modality, specifically monoclonal antibodies, antibody-drug conjugates, and bispecific T-cell antibodies in the treatment of multiple myeloma.

Recent findings: Three monoclonal antibodies (daratumumab, isatuximab, elotuzumab) and one anti-BCMA (B-cell maturation antigen) antibody-drug conjugate (belantamab mafodotin) have been approved by the FDA in the last 5 years for the treatment of multiple myeloma. There are many ongoing clinical trials using novel targets and constructs, including bispecific antibodies against BCMA, GPRC5D, and FCRH5. In addition to exploring efficacy, there are ongoing efforts to overcome the resistance to therapy. Antibody-based therapy has improved the outcomes of patients with multiple myeloma and has been incorporated in the standard of care. We expect to see novel targets and constructs that can achieve a deeper and more durable response while minimizing toxicity, as well as better strategies for toxicity management for existing agents. We also expect that antibody-based strategies will be used in earlier lines of therapy in the future.

Trial registration: ClinicalTrials.gov NCT04126200.

Keywords: Antibody-drug conjugate; BCMA; Bispecific T-cell antibodies; CD38; Monoclonal antibody; Multiple myeloma.

Figure 1:

Different Antibody-based Therapies for Treatment of Multiple Myeloma: Monoclonal Antibodies, Antibody Drug Conjugates and Bispecific Antibodies