Vaccine Development in Myeloma: Are We There Yet?

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Topics include: Treatments and Understanding

What can patients expect to see in the area of myeloma vaccine therapy? Vaccine therapy may be useful for MGUS and smoldering myeloma patients to prevent progression, and those with active myeloma to maintain MRD-negative status after transplant. Watch as Dr. Noopur Raje, from the Massachusetts General Hospital Cancer Center, shares the current status of vaccine development for each different myeloma disease state.

Produced by Patient Power in partnership with The University of Texas MD Anderson Cancer Center. We thank AbbVie Inc. and Takeda Oncology for their support.

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Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

Jack Aiello:

Dr. Raje, maybe you can enlighten us as to what vaccines mean for myeloma patients.

Dr. Raje:                

When you think about a vaccine, you brought up the analogy of the flu shot, Jack, and the flu shot is you try and immunize a patient, so you don't get the flu. The way we are thinking about using vaccines in myeloma, at least the study you have listed out there, the PVX-410 vaccine, this is an off-the-shelf vaccine. It's a vaccine which incorporates three different proteins which are expressed on myeloma cells. These include SLAMF7, which is the same protein against elotuzumab (Empliciti), CD138 which is how we identify myeloma cells, and another protein called XBP1, which all myeloma cells will have.

What we are thinking of doing here is thinking of using it early on, so not using a vaccine when you've actually developed active myeloma but using it—with myeloma, you have a precursor disease state. You have the MGUS patients, and you have smoldering myeloma patients, and what we have been able to do over the last few years is figure out who are the ones who can actually progress to myeloma. 

With this vaccine, the idea here is to try and educate the immune system of the patient so that they do not develop active myeloma. We are using the vaccine, the PVX specifically in the smoldering myeloma space, in moderate and high-risk patients so that they never do develop active myeloma. The idea here being give the vaccine to a patient, have the T cells recognize that as a foreign protein, and then suppress those myeloma cells from growing and becoming active in the future. We've actually used it in a few patients alone and in combination with lenalidomide (Revlimid). And what's been to me the most striking piece here is we are seeing the persistence around the development of memory T cells.

Now, memory T cells are T cells which have the memory of recognizing tumor as foreign and preventing that from growing. Obviously, this is early days, and we've got to wait and see whether or not they do not progress. The other one which you have up on that list, the MMDC fusion, we're using it in a slightly different space, so this is for patients with active disease. But this is a vaccine we're giving post-autologous stem cell transplant, and the idea is to keep those under good control in an MRD-negative state.     

This is more a designer-specific vaccine wherein we are taking dendritic cells which are the antigen presenting cells of patients from the patient. We're collecting tumor from the patient. We're fusing the two and then giving back to patients. This is something that has been led by one of my colleagues in Boston, Dr. David Avigan, who has done amazing work, and it's a trial which is available all over the country.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

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Page last updated on January 22, 2018