​Dr. Shah on the Potential of Vaccine-Based Therapy in Multiple Myeloma

Nina Shah, MD, hematologist and oncologist, associate professor of medicine, Department of Medicine, University of California, San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center, discusses the potential of vaccine-based therapies in multiple myeloma.

Multiple myeloma is characterized by immunosuppression, both in terms of the disease and therapies given, Shah says. Vaccine-based treatment approaches may train the immune system to inherently fight the myeloma without the need for additional drugs, Shah explains. For example, the phase 2 BMT CTN 1401 study (NCT02728102) in which the patient's plasma cells are fused to dendritic cells, creating a personalized vaccine therapy. The treatment is given after transplant as the immune system is reconstituting, Shah adds.

By giving these vaccines in the setting of lenalidomide (Revlimid), a patient's immune system could be retrained to have T-cell memory against multiple myeloma as these proteins are being presented by dendritic cells that haven't been fused to myeloma cells, Shah continues. The antigens that are being used to train the immune system are unknown, but they are the patient's own antigens, Shah adds. 

Moving forward, understanding how durable the effects of vaccine-based approaches are will be important. Additionally, correlative data—some of which suggest that patients have increased T-cell clonality and myeloma-specific T-cell reactivity after multiple cycles of vaccination—could showcase the utility of this therapeutic approach, Shah concludes.