Anti-CD38 and anti-SLAMF7: the future of myeloma immunotherapy

ABSTRACT

Introduction: the high expression of a number of surface antigens on malignant plasma cells, the bone marrow micro-environment and immune effector T cells, makes these appealing targets for immune therapy with monoclonal antibodies (mAbs).

Areas covered: Two mAbs, anti-CD38 daratumumab (Dara) and anti-SLAMF7 elotuzumab (Elo), have achieved recent regulatory approval for relapsed or refractory MM (RRMM) and are currently being explored as possible treatment options in novel combinations and different settings. This review discusses the current landscape and possible development of anti-CD38 and anti-SLAMF7 mAbs.

Expert commentary: Three phase III trials demonstrated a significant advantage in terms of response and PFS when Dara or Elo are combined with lenalidomide-dexamethsone (Rd) or bortezomib-dexamethsone (Vd), in comparison to doublet regimens, for patients with RRMM. Treatment algorithms including Dara- or Elo-based triplets may be defined on the basis of disease and patients’ characteristics, as well as of their prior exposure to different classes of novel agents. Evaluation of these agents in new combination regimens, including second and third generation PIs and IMiDs, are under investigation. Moreover, use of mAbs in phases of the disease where the immune system is less compromised, such as newly diagnosed MM or even high-risk smoldering myeloma, appears logical.

KEYWORDS:

• Anti-CD38
• anti-SLAMF7
• monoclonal antibodies
• multiple myeloma

Declaration of interest

E Zamagni has received honoraria from and served on the advisory board for Janssen, Celgene, Bristol-Myer Squibb, Takeda, and Amgen. P Tacchetti has received honoraria from Janssen, Celgene, Bristol-Myer Squibb, and Amgen. M Cavo has received honoraria and served on the advisory board for Janssen, Celgene, Bristol-Myer Squibb, Takeda, Amgen, and Novartis. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

One peer review receives project funding from Genmab and Janssen Pharma but have no other relevant financial relationships to disclose.

Additional information

Funding

This paper was not funded.