INNATE
Your Defense
Team Line Up
Natural Killer Cells
ADAPTIVE
Microphages
Dendritic Cells
T-cells
B-cells
How monoclonal antibody drugs work
Imagine if it were possible for a molecule
The potential for elotuzumab to
immune system to seek and destroy the
to be created that could essentially
provide long-term sustained remission
specific myeloma cells the same way it
mimic our body’s natural antibodies,
looks encouraging, particularly when
would any other invader.
locating cancer cells and putting a
used in combination with other drugs
bullseye on their backs so that the
(such as Revlimid).
immune system can attack and kill them.
A national study supported by the MMRF,
which took patients going through a
Another mAb in consideration for FDA
transplant to see how a vaccine such as
That’s the idea behind monoclonal
approval is daratumumab, and other
this might be an important component
antibodies (mAbs). These are large
monoclonal antibodies are in clinical
in stimulating the immune system and
proteins that are engineered in the lab to
development for myeloma as well.
potentially targeting leftover disease
attach to specific proteins on the surface
We’ve only just scratched the surface.
after the transplant, is showing potential.
In yet another approach, the DNA
the cancer cell can be killed either by a
Re-educating dendritic
cells with vaccines
direct effect, such as a toxin or radioactive
Though myeloma cells have the
isotope which is also carried by the mAb,
antigens present to be recognized
or by recruiting NK cells to stick to them,
by the immune system, the cells are
thus activating other elements of the
able to “hide,” or be surrounded by
immune system to respond.
inhibitory cells, and actively shut down
of the cancer cell to make it more visible
to the immune system. Once attached,
The drug elotuzumab, which has
potentially reactive T-cells.
of myeloma cells of an individual
patient are sequenced and compared
to normal DNA sequences from the
same patient to identify mutations.
Producing synthetic versions of the
proteins with the mutation in them can
form the basis of a vaccine that will
stimulate the mutation-specific T-cells
completed phase 3 clinical trials, and
The idea behind cancer vaccines is to
to identify and kill them. Clinical trials
is being evaluated by the FDA for
create a new “education system” for
for vaccine strategies such as these are
potential approval, is one such mAb. It
the T-cells so that they recognize the
going on throughout the country.
binds the protein SLAMF7 (also known
myeloma cells as foreign and go after
as CS-1), which is present on myeloma
them without restraint. One of the
cells, but also NK cells. Therefore, it
key players in this strategy is called
flags the tumor cells and activates
dendritic cells. These play an important
the “foot soldier” cells that can kill the
role in bridging innate immune responses
tumor cells. The MMRF helped drive
with adaptive responses.
The potential for immunotherapy and
other precise and highly personalized
approaches to cancer treatment has
never been more profound and have the
potential to extend lives and find cures.
participation in this drug’s early clinical
trials, which built the foundation of
One approach is to inject patient-derived
proof necessary to get to phase 3 trials,
tumor cells fused with their own dendritic
and also invested in compounds that led
cells or those generated outside the body.
to its development.
This in essence “teaches” the patient’s
I M M U N OT H E R AP Y
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