New Advances In Myeloma Vaccines – Part 1: Introduction

This article is the first in a five-part series about emerging vaccines for multiple myeloma. It provides an introduction to the concept of a myeloma vaccine. The second article provides an introduction to the various types of vaccines that are currently under development for myeloma, the third article describes vaccines for which clinical trials have been completed, the fourth article focuses on ongoing vaccine research, and the fifth article tells the story of a patient who participated in a myeloma vaccine clinical trial.
A Search For The Cure
Multiple myeloma is the second most prevalent blood cancer in the United States. Despite advances in drug combination therapies and stem cell transplantation techniques, multiple myeloma is still considered an incurable disease (see related Beacon news).
While options for the management of myeloma continue to improve, disease relapse remains common. With the emergence of many novel therapies, developing treatments that cure myeloma is the research goal of many scientists.
One treatment strategy that has attracted attention from researchers is therapeutic vaccination, a form of “immunotherapy” that harnesses the immune system to fight and destroy cancer cells.
The goal of therapeutic vaccination is to activate cells in the immune system to recognize tumor cells as “foreign,” ultimately resulting in their destruction.
Dr. Maurizio Bendandi, a physician currently conducting myeloma vaccine research at the University of Navarra in Spain, believes that the development of a safe and effective vaccine could ultimately be used as an alternative maintenance option for myeloma patients.
Preventative Versus Therapeutic Vaccination
People are typically familiar with preventative vaccines, which as their name suggests are used to prevent a disease. Therapeutic vaccines, however, are used to treat or cure an already existing disease. Therapeutic vaccines are the type being studied for the treatment of multiple myeloma.
Preventative vaccines work by exposing patients to a safe form of a disease-causing agent (pathogen), most often a weakened or killed form of a virus. The immune response to the safe form of the pathogen is often enough to completely protect patients from disease caused by the active form of the pathogen years after the person receives the vaccine.
Since the late eighteenth century, preventative vaccination has forever changed medicine and its practice. Diseases such as polio and smallpox have essentially been eradicated due to preventative vaccination. In 2009, the FDA approved Gardasil, a vaccine against human papillomavirus, making it the first vaccine available for the prevention of cancer.
Although the development, production, and distribution of preventative vaccines exploded during the 20th century, the development of therapeutic vaccines, which can be used to treat already existing disease, remains a challenging area of research.
Therapeutic cancer vaccines have been intensely researched for more than a decade. So far, only one has been approved for use in the United States. Provenge (sipuleucel-T) received FDA approval in April of last year for the treatment of certain men with advanced prostate cancer.
Unlike preventative vaccination, which stimulates a protective immune response before disease occurs, therapeutic vaccination must stimulate an immune response against an already established disease, a process that has proven to be very difficult to initiate and sustain.
Pathogens differ greatly from human cells, and are therefore more easily recognized by the immune system as “foreign.”
Cancer, on the other hand, arises from mutations in human cells. When developing therapeutic vaccines for myeloma, researchers must vaccinate against components that are present in cancerous cells but not normal cells. If the vaccine component is not specific enough to the cancerous cells, the immune system may not respond at all, or it may begin to recognize normal cells as “foreign,” resulting in their destruction.
Dr. Ravi Vij, a myeloma expert and researcher from Washington University in St. Louis, said that myeloma vaccines could conceivably lengthen progression-free survival with minimal side effects. However, he also said that there are several hurdles that must be overcome, including finding the right targets to generate the vaccine as well as making the vaccine elicit a strong enough immune response.
Related Articles:
- Dr. Christoph Driessen On Nelfinavir In The Treatment Of Multiple Myeloma
- Getting To Know: Tiragolumab
- Nelfinavir-Velcade Combination Very Active In Advanced, Velcade-Resistant Multiple Myeloma
- Darzalex May Affect Different Uninvolved Immunoglobulins Differently
- Nelfinavir Shows Only Limited Success In Overcoming Revlimid Resistance In Multiple Myeloma Patients
Melissa: I'm looking forward to reading your series on how vaccines might play a role in MM treatment. Many thanks to you and all at the MB. Keep up the great work!
Dear Melissa, you selected a great topic. Thank you for the informations. Perhaps you might write also about the important trial the myeloma commmunity is waiting for with accelerated heartbeats. It's the vaccine trial from UAMS/Arkansas, that has been leaded by Frits van Rhee. The immunotherapy specialist and Director of Clinical research director van Rhee recently left Arkansas and will build up a cancer centre in St. Francis. Here is the link of "natural born killers" featering van rhee's work: http://www.uamshealth.com/?id=7669&sid=1
Again, thank you for great work! Peter
Thank you both for your positive feedback on the article and interest in the vaccine series. Peter, please see the upcoming vaccine series articles for more information regarding the work being done at UAMS/Arkansas. In addition to the work you have linked to here, Frits van Rhee is also leading a Phase 2/3 clinical trial for a therapeutic myeloma vaccine based on the protein MAGE-A3. MAGE-A3 is frequently produced by myeloma cells in high-risk patients. More detailed information regarding this trial will be included in the fourth part of this series. Thank you again for your interest.
Dear Melissa:
Article was interesting. I lost my husband Buddy Huber to multiple Myeloma this month after a 23 month battle. He was diagnosed in stage 4 on 3/17/09 and underwent usual chemo and underwent a stem cell transplant and participated in a clinical trial. Hopefully the information gained from the clinical trial at NY Presbyterian helps and together with work being done at UAMS/Arkansas and other facilities, they will come up a myeloma vaccine or better treatment for the disease.
Jean Huber
Jean, thank you for sharing you and your husband's experiences with me and the Beacon readers. I am sorry for your loss and wish you the best during this difficult time.
My husband is a myeloma patient. We are interested in any info you may have on research and available drug treatments. This article is very interesting and gives us hope.