New Treatments for Multiple Myeloma

Multiple myeloma(MM) is malignant hematologic disease characterized by the clonalproliferation of malignant plasma cells. The treatment of MM has changed dramatically in recentyears, with the introduction of new drugs into therapeutic strategies, both in the front line settingand in relapsed refractory disease. However, most patients eventually relapse and oftendemonstrate multiple drug resistance. Therefore, we need more new agent for refractory andrecurrent disease.In recent years, many antibody therapies for multiple myeloma have been developed.Antibodies against SLAMF7, CD38, B-cell maturation antigen and PD-1 have been developed andclinical trials are currently under way.Antibodies are proteins made by the body’s immune system to help fight infections. Man-madeversions (monoclonal antibodies), can be designed to attack specific target, such as proteins on thesurface of myeloma cells. Daratumumab is monoclonal antibody that attaches to the CD38protein, which is found on myeloma cells. This is thought to both kill the cancer cells directly and tohelp the immune system attack them also.Elotuzumab is humanized IgG1-kappa monoclonal antibody targeting human SLAMF7. Bindingof elotuzumab to natural killer cells leads to activation of natural killer cells, resulting in antibodydependent cell-mediated cytotoxicity of elotuzumab-bound multiple myeloma cells, but notcomplement-dependent cytotoxicity.A new Immunomodulating agents is Pomalidomide and is also related to thalidomide andis used to treat multiple myeloma. The risk of nerve damage is not as severe as it is with the otherimmunomodulating drugs, but it’s also linked to an increased risk of blood clots Carfilzomib is newer proteasome inhibitor that can be used to treat multiple myeloma inpatients who have already been treated with other drugs that didn work, also Ixazomib is aproteasome inhibitor that is is usually given after other drugs have been tried.Histone deacetylase (HDAC) inhibitors are group of drugs that can affect which genes are activeor turned on inside cells. They do this by interacting with proteins in chromosomes called histones.Panobinostat is an HDAC inhibitor that can be used to treat patients who have already been treatedwith bortezomib and an immunomodulating agent