Your immune system helps your body fight sickness by attacking bacteria or viruses. Immunotherapy is a cancer treatment that uses your immune system to fight and kill cancer cells.

T cells are part of your immune system. They are white blood cells that tell your body what it should fight. T cells usually fight infections, but they can also fight cancer. We can change T cells in a lab so they can find and kill cancer cells

Immunotherapy for multiple myeloma

These are the immunotherapy treatments approved to treat multiple myeloma:

• Monoclonal antibodies
• Bispecific antibodies
• CAR T Cell therapy

How monoclonal antibodies treat multiple myeloma

Monoclonal antibodies are proteins made in a lab to find and bind to certain targets.

Monoclonal antibodies work by attaching themselves to the surface of myeloma cells. This exposes myeloma cells to an attack from your immune system.

Three monoclonal antibodies that fight multiple myeloma

• Daratumumab targets a marker on myeloma cells called CD38. It’s used alone or together with other drugs.  Daratumumab is given as an intravenous infusion (in your veins) or is injected under your skin.
• Isatuximab (Sarclisa®) also targets CD38. It’s usually given as an intravenous infusion along with other drugs.
• Elotuzumab (Empliciti®) targets a marker called SLAMF7. It’s given as an intravenous infusion along with other drugs.

How bispecific antibodies treat multiple myeloma

Bispecific antibodies are newer drugs for multiple myeloma. They bind to 2 different antigens at the same time, giving us 2 targets to fight cancer. Monoclonal antibodies target just 1 antigen.

One part of the antibody binds to an antigen on you own T cells. This can be the antigen called CD3. The other part of the antibody binds to an antigen on the myeloma cell. This can be the antigens called BCMA, GPRC5D, or FcHR5.

Teclistamab for multiple myeloma

Teclistamab is a bispecific antibody that targets an antigen on a myeloma cell called BCMA. Teclistamab works well for people with multiple myeloma that did not respond to other treatments.

There was a promising research study about teclistamab in 2022. The drug was given to 165 people who had not done well with at least 3 other therapies. More than 6 out of every 10 people (63%) improved. Among them, nearly 4 out of every 10 were in complete remission.

CAR T cell therapy for multiple myeloma

Your immune system’s job is to help your body fight infections.

Chimeric antigen receptor (CAR) T cell therapy is a type of immunotherapy. CAR refers to a receptor that’s on immune cells called T cells. CAR T cell therapy involves removing T cells from your blood. In a lab, we introduce a new gene into the T cells that  lets them find and attack cancer cells. They become CAR T cells.

Next, we put the changed cells back into your bloodstream. They multiply and start the immune responses aimed at fighting cancer.

Most CAR T therapies for multiple myeloma target an antigen called BCMA. They are idecabtagene vicleucel (Abecma® and ciltacabtagene autoleucel, also known as cilta-cel (Carvytki™).

We’re also researching other promising CAR T cell therapies. MSK led a research study, also known as a clinical trial, about a new CAR T cell therapy targeting an antigen called GPRC5D.

See a list of current clinical trials for multiple myeloma at MSK.