Figure 2. Immunotherapies for myeloma.
Immunotherapies for myeloma target the tumor itself, suppressive myeloid populations, and/or immune cells. CD38-targeted mAbs target CD38-expressing myeloma cells and suppressive myeloid cells by antibody-dependent cell-mediated cytotoxicity (ADCC), complement-dependent cytotoxicity (CDC), and antibody-dependent cellular phagocytosis (ADCP), which also facilitates immune cell activation. Autologous stem cell transplantation (ASCT) disrupts the tumor microenvironment (TME), directly eliminates myeloma cells, and promotes T cell–mediated antimyeloma responses. Chimeric antigen receptor T cells (CAR T) and oncolytic viruses directly promote lysis of myeloma cells. Immune checkpoint inhibitors and cancer vaccination approaches directly enhance T and NK cell–mediated antimyeloma responses. Immunomodulatory imide drugs (IMiDs) directly inhibit myeloma cell growth, reduce angiogenesis, and promote immune cell activation.