Using Immune Therapy to Fight Multiple Myeloma

Multiple myeloma can impact your immune system, making you vulnerable to infections. But there is potential for your immune system to fight back. Immunotherapy offers a way to strengthen your defenses and target myeloma cells. By boosting your body's natural defenses, these therapies provide a targeted and effective way to manage myeloma. The International Myeloma Foundation is here to explain how.

What Is Immune Therapy?

Your immune system consists of organs, specialized cells, and other substances that protect your body from infections and diseases. In the case of myeloma and other cancers, the immune system can have trouble targeting the “bad” cells. This is because cancer most often begins in normal cells, making it difficult for the immune system to identify cancer cells as foreign.

Immune therapies, or immunotherapies, are types of treatments that help your immune system fight cancer. They use the body’s immune system to help fight infections and attack cancer cells. This treatment can also involve laboratory-created substances that behave just like your immune system to support your body's attempts to find and attack the cancer cells.

How Does Immunotherapy Fight Myeloma? 

When the immune system is functioning normally, it will find and destroy abnormal cells. As a result, the immune system may prevent or slow the growth of many cancers.  

Yet, cancer cells have ways to avoid the immune system’s ability to destroy them. For example, according to the National Cancer Institute, cancer cells: 

• Sometimes, they develop genetic mutations that reduce their visibility to the immune system.
• Certain proteins on the surface of cancer cells can deactivate immune cells.
• Cancer cells can also modify the environment around the tumor, hindering the immune system's ability to target them.

Immune therapies are designed to improve the immune system's effectiveness in fighting cancer by counteracting these mechanisms.

What Are the Types of Immune Therapies? 

There are various types of immune therapies, such as:

• Monoclonal antibodies 
• Antibody-drug conjugates (ADCs) 
• Bispecific T-cell Engagers (BiTEs®) 
• CAR T cells 
• Checkpoint inhibitors 
• Vaccine therapies 
• Oncolytic virotherapy 
• Certain combination therapies, including immunomodulatory drugs and proteasome inhibitors 

Learn more about each type of immune therapy and the immune system as a whole.

What Is BCMA?

BCMA (B-cell maturation antigen) is a target for multiple myeloma treatment. It's a protein found on the surface of most multiple myeloma cells, as well as healthy B cells — a type of white blood cell. By targeting this protein, researchers are hoping to improve outcomes for patients with this challenging disease. Here's a breakdown of why BCMA is important in the context of myeloma:

• Target for immunotherapy: Because BCMA is so prevalent in myeloma cells, it makes an excellent target for immunotherapy. 
• Normal B-cell development: BCMA plays a role in the survival and maturation of normal B cells, which are important for producing antibodies to fight infection.
• Myeloma cell survival: BCMA signaling contributes to the survival and growth of myeloma cells.

BCMA is a key target in the development of new and innovative treatments for multiple myeloma. Researchers have developed several types of immunotherapies that specifically target BCMA:

• CAR T-cell therapy: CAR T-cell therapy is genetically engineered T cells designed to recognize and attack BCMA-expressing myeloma cells.
• Bispecific antibodies: These antibodies bind to BCMA on myeloma cells and T cells, bringing them together to kill the myeloma cells.
• Antibody-drug conjugates (ADCs): Antibody drug conjugates are antibodies that bind to BCMA and deliver a toxic drug directly to the myeloma cells.

A Deeper Dive Into Bispecific Therapies

Bispecific therapies, also known as bispecific antibodies, are a type of immunotherapy designed to fight multiple myeloma by engaging two different targets simultaneously. Think of them as bridge molecules that bring two cells together to achieve a specific goal.

How Do Bispecific Antibodies Work?

 The design of bispecific antibodies allows them to bind to two different antigens simultaneously. In the context of multiple myeloma, one arm of the antibody typically binds to a target on the surface of cancer cells — like BCMA — while the other arm binds to a target on an immune cell, such as a T cell.

By binding to both a cancer cell and an immune cell, the bispecific antibody brings the immune cell into close proximity to the cancer cell. This activates the immune cell, triggering it to kill the cancer cell.

Resources on Immunotherapy and Myeloma

IMF Chief Medical Officer Dr. Joseph Mikhael discusses the basics of immunotherapy, monoclonal and bispecific antibodies, CAR T-cell therapy, and the benefits of bispecific antibody therapies in the resources below:

• Bispecifics part one: This video explains our immune system and the basics of immunotherapy.
• Bispecifics part two: Dr. Joseph Mikhael explains monoclonal and bispecific antibodies.
• Bispecifics part three: Learn about the pros and cons of bispecific.
• Bispecifics part four: The final video explains the science of bispecific antibodies.

The International Myeloma Foundation Is Here to Support You

Facing myeloma is a long journey, but it is not an isolated one! Find a support group near you today or download more resources to stay informed. We're here to help. Give us a call. If you're based in the USA or Canada, call 800-452 CURE (2873). For patients worldwide, contact us at 1-818-487-7455.