The treatment of patients with multiple myeloma is poised to undergo a dramatic transformation, as novel monoclonal antibodies and combination strategies race toward approval. To gain insight into this rapidly changing treatment environment, OncLive interviewed multiple myeloma expert Kenneth C. Anderson, MD, from the Dana-Farber Cancer Institute and a Giant of Cancer Care in Multiple Myeloma, on the new agents currently in development. 
OncLive: What are some of the most promising agents currently being explored in the field of multiple myeloma?
Anderson: Monoclonal antibodies, or in particular immunotherapies, have been an area of research in myeloma for many decades. There are two main targets for monoclonal antibodies that look very promising at the present time. The first one is elotuzumab, which is directed at an antigen called SLAMF7. We and others have found this antigen in patient tumor cells and we have studied the function of SLAMF7 on multiple myeloma cells and found that a humanized antibody directed against that target mediated antibody-dependent cellular cytotoxicity.
This and much other experimental data, contributed to the rationale to go quickly to the clinic. As a single agent, elotuzumab achieved stable disease in patients whose myeloma was progressing.
Excitingly, because of Dr Tai’s work showing that lenalidomide, the immunomodulatory drug, added to elotuzumab upregulated its activity in our preclinical models, this was quickly translated and 80% to 90% of people responded, with responses lasting up to 33 months including relapsed/refractory and high-risk myeloma patients.
Phase III trials have already been completed and this particular antibody will probably be approved sometime in 2015.
The target called CD38 is a little different from SLAMF7 because it’s expressed surely on myeloma cells but on many other cells too. These cells include immune-effector cells or endothelial cells. So we were fearful that there might not be a therapeutic index or a therapeutic window if we were to target this antigen, the adverse effects might be prohibitive. 
Suffice it to say that there are antibodies, humanized antibodies, against CD38. One is called daratumumab and a second one is called SAR (SAR650984). Both of these CD38 antibodies have single agent activity but both are now going forward combined with lenalidomide, because this can markedly increase the antibody-dependent cellular cytotoxicity and the frequency of response.

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