Thanks to our episode sponsor, Takeda Oncology Dr. Don Benson, MD, PhD Ohio State University Interview Date: September 18, 2015 Summary The world of potential multiple myeloma immunotherapies is growing. Dr. Don Benson of Ohio State University shares his deep knowledge of the field. He reviews the four classes of immune therapies - 1) cellular therapy like transplant and CAR T cells 2) monoclonal antibodies 3) cytokine treatments and 4) vaccines. He first reviews the upcoming monoclonal antibodies, which are expected to be FDA approved soon. Elotuzumab will likely be the first approved before year-end and targets the CS1 protein. On its heels is daratumumab, which targets the CD38 protein. In the field of monoclonal antibodies, he describes two classes - the first stick to the myeloma cells themselves and either kill myeloma directly or flag the immune system to kill them. The second stick to immune cells in the body and can change their function. Can these be used together? Yes! He shares a study to use both kinds of monoclonal antibodies. He also notes that the personalized nature of their use may be critical. As an example as part of a isatuximab trial, he found that for certain patients that showed a certain inhibatory receptor on their cells, 90% of them responded to this immunotherapy while 50-60% of the others in the study responded. He shares that knowing BOTH your genetics and your immune system features will be critical to getting truly personalized care. With these upcoming drugs, he discusses how expanded use and compassionate use programs work and how patients can find more information. He discusses the excitement around CAR T cell therapy, with recently published results in the New England Journal of Medicine showing that this type of treatment may have killed the myeloma stem cell clone - the source of relapse. There is much to learn and be excited about in this important show. Clinical Trials Discussed in This Show Elotuzumab with either Lirilumumab or Urelumab (2 kinds of monoclonal antibodies) Elotuzumab with lenalidomide and dex Pidilizumab and lenalidomide for relapsed/refractory myeloma Elotuzumab. lenalidomide and dex for smoldering myeloma The Myeloma Crowd Radio Show with Dr. Don Benson