부산대학교 도서관

Simple Summary: Multiple myeloma (MM) is a hematological malignancy caused by aberrations in the plasma cell development, resulting in uncontrolled production of plasma cells and or monoclonal proteins. Currently, several treatments are centered around immune-based therapies including immunomodulatory agents, monoclonal antibodies, cellular therapies, and stem cell transplantation. We review the biologic rationale, efficacy, side effects, and limitations of immune-checkpoint inhibitors (ICIs), which have been successful in several solid organ malignancies such as melanoma, kidney, and lung cancers. Recent clinical trials evaluating ICIs as monotherapy and in combination with approved pharmaceutical drugs in MM, have thus far remained underwhelming due to excessive side effects and lack of efficacy in aggressive and advanced cases. There may be a role for ICIs in early forms of MM and preventing recurrence once achieving remission. Side effect mitigation and improved efficacy to combat resistance are needed prior to profoundly impacting the current MM landscape. Clinical studies to answer these questions are ongoing, and we eagerly await this data to determine if ICIs will become a permanent fixture in MM. Immune dysregulation and alteration of the bone marrow microenvironment allowing plasma cells to escape immune surveillance are well-known factors associated with the proliferation of clonal plasma cells and development of multiple myeloma (MM). Whilst immunotherapeutic approaches are now commonplace in a wide spectrum of malignancies, this aberration of myeloma development gives rise to the biological rationale for the use of immune checkpoint inhibitors (ICIs) in MM. However, the initial experience with these agents has been challenging with limited single agent efficacy, significant toxicity, and side effects. Herein, we review the biological and immunological aspects of MM and ICIs. We discuss the basic biology of immune checkpoint inhibitors, mechanisms of resistance, and drug failure patterns, review the published clinical trial data for ICIs in MM, and look towards the future of ICIs for MM treatment. [ABSTRACT FROM AUTHOR]