What are the different kinds of myeloma vaccines being explored?

What are myeloma vaccines? There are many different types of myeloma vaccines currently being developed. There are peptides. Peptides are the small parts, the fragments of proteins that are being manufactured and injected under the skin. There are fusion cells. So for example, a combination of a myeloma cell with another cell that effectively primes an immune response called the dendritic cell that you fuse these two together and you get the ability of this myeloma cell to be effectively recognized by the immune system. We have been using an approach where we take myeloma cell lines and combine it with another cell that makes a protein that calls the immune system in. That protein is called GMCSF. And that's called an allogeneic cell vaccine. This is an off-the-shelf cell product that we can give to everybody because then our immune system will personally show the proteins that need to be recognized for each individual. They're being used in a variety of different settings. The peptide vaccines that I'm aware of are currently being used in the smoldering myeloma setting to see if it can prevent the transition to active myeloma. There is the fusion vaccine that is currently being used following an autologous transplant to see if transplant plus vaccination can improve the overall benefits of the transplant itself. We are using our vaccine in the setting of minimal residual disease to see whether we can prolong what we call the progression-free survival or the ability of the patient's sustained remission. I think each one of these settings are important to look at and clearly there's a role for this kind of therapy in each one of these settings. And ultimately we're going to have to see what kind of results we get and what the next steps will be based on those initial results. There are a number of different vaccine modalities. There are dendritic cells vaccines. There are peptide-based vaccines that Dr. Avigan here at the Mass General Group are using. There are other dendritic cell vaccines that the group down in MD Anderson Cancer Center are using. And the goal for the peptide vaccine is partly to try and see if it can be used to prevent people from going from smoldering myeloma to active multiple myeloma. I think there's a number of other modalities that people are using but these are some of the ones that are in the front line. The crucial thing here to understand is that this is not the kind of therapy that you've been reading about such as CAR T cell therapy. This is a much more subtle method of trying to keep things in check and under control. It may not necessarily eliminate the cancer entirely but it will certainly we think help keep it under control for longer periods of time.