Progress of Therapeutic Antibodies in the Treatment of Patients with Multiple Myeloma and Possible Impacts of Antibodies on the Evaluation of Response to the Treatment
Year: 2024
Type: article
Abstract: Multiple myeloma (MM) is an incurable hematological malignancy. Introduction of autologous stem cell transplantation, as well as proteasome inhibitors and immunomodulatory drugs (IMiDs) has improved the treatment results. However, many patients develop resistance to existing therapies, and novel treatment strategies for these patients must be established. Therapeutic antibodies including daratumumab or isatuximab targeting CD38 and elotuzumab targeting SLAMF7 have been introduced in the clinic as immunotherapies for MM. These antibodies exert cytotoxic effects on myeloma cells through the activation of effector cells such as natural killer cells and induction of phagocytosis by macrophages. The recent studies suggest the possibility of therapeutic antibodies to bring about influence on testing in treatment of MM. CD38 is one of the antigens used for detection of myeloma cells in flowcytometry. The use of daratumumab is supposed to downregulate CD38 expression in myeloma cells. Thus, daratumumab treatment may affect the evaluation of minimal residual disease (MRD) by flow cytometry. Immunofixation electrophoresis (IFE) to detect monoclonal protein is essential for evaluation of response to treatment. Both daratumumab and elotuzumab are derived from human IgG-k and their administration may affect the evaluation of immunofixation electrophoresis if the tumor-derived M protein belongs to the same IgG-k subclass. To overcome the influence of therapeutic antibodies on testing, a method for detecting MRD using different antibodies from conventional ones and daratumumab-specific immunofixation electrophoresis reflex assay (DIRA) for IFE have been introduced. In this review, progress of therapeutic antibodies and possible impacts of these antibodies on the evaluation of response to the treatment will be discussed.
Authors: Imai, Yoichi, Handa, Tomoyuki, Mitani, Kinuko
Institution: Dokkyo Medical University
Language: Japanese
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7146862333