Deciphering mechanisms of immune escape to inform immunotherapeutic strategies in multiple myeloma.
Muthulekha SwamydasElena V MurphyJames J Ignatz-HooverEhsan MalekJames J DriscollPublished in: Journal of hematology & oncology (2022)
Multiple myeloma is an incurable cancer characterized by the uncontrolled growth of malignant plasma cells nurtured within a permissive bone marrow microenvironment. While patients mount numerous adaptive immune responses directed against their disease, emerging data demonstrate that tumor intrinsic and extrinsic mechanisms allow myeloma cells to subvert host immunosurveillance and resist current therapeutic strategies. Myeloma downregulates antigens recognized by cellular immunity and modulates the bone marrow microenvironment to promote uncontrolled tumor proliferation, apoptotic resistance, and further hamper anti-tumor immunity. Additional resistance often develops after an initial clinical response to small molecules, immune-targeting antibodies, immune checkpoint blockade or cellular immunotherapy. Profound quantitative and qualitative dysfunction of numerous immune effector cell types that confer anti-myeloma immunity further supports myelomagenesis, disease progression and the emergence of drug resistance. Identification of tumor intrinsic and extrinsic resistance mechanisms may direct the design of rationally-designed drug combinations that prevent or overcome drug resistance to improve patient survival. Here, we summarize various mechanisms of immune escape as a means to inform novel strategies that may restore and improve host anti-myeloma immunity.
Keyphrases
- multiple myeloma
- bone marrow
- newly diagnosed
- induced apoptosis
- cell cycle arrest
- immune response
- stem cells
- mesenchymal stem cells
- dendritic cells
- cell death
- ejection fraction
- signaling pathway
- oxidative stress
- case report
- systematic review
- single cell
- squamous cell carcinoma
- drug delivery
- machine learning
- papillary thyroid
- inflammatory response
- endoplasmic reticulum stress
- cell proliferation
- regulatory t cells
- cell therapy
- artificial intelligence
- data analysis
- pi k akt
- childhood cancer