Immunotherapeutical approaches for multiple myeloma

Multiple myeloma (MM) is characterized by deep immunodeficiency caused by many factors including uncontrolled production of monoclonal immunoglobulin and inhibitory effect of microenvironment. Despite the use of different therapeutic strategies as drug treatment, chemotherapy and stem cell transplantation still remains an incurable disease. Novel treatment modalities introduced for MM significantly increased overall survival, but it still reaches not more than 4 years. Therefore there is a necessity to generate novel therapeutical strategies that successfully improve quality of MM patients life and cause complete recovery. Tumor-associated antigens (TAA) are potential targets for cancer immunotherapy due to their limited expression on normal tissues or restriction to tumor cells. Epitopes derived from TAA induce specific, cytotoxic T lymphocytes which are able to recognize and eradicate myeloma cells with good efficacy. These features allow to construct various types of peptide-based vaccines, which could prolong MM patients life and lead to complete remission. In this work we have characterized (C/T), human telomerase reverse transcriptase (hTERT), X-box binding protein 1 (XBP-1), PAS domain-containing protein 1 (PASD-1), receptor for hyaluronic acid-mediated motility (RHAMM), mucin 1 (MUC-1), Wilms Tumor-1 (WT1), that might represent a target for peptide-based immunotherapy. Results from first clinical trials on immunotherapy in MM were also characterized.