Which medications in the drug class Monoclonal Antibodies are used in the treatment of Multiple Myeloma?

Updated: Sep 30, 2019
  • Author: Dhaval Shah, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Monoclonal Antibodies

Monoclonal antibodies that target RANKL are used to prevent skeletal-related events (SREs).

Denosumab (Xgeva)

Monoclonal antibody that specifically targets RANKL. It binds to RANKL and inhibits its binding to RANK receptor, thereby preventing osteoclast formation. This results in decreased bone resorption and increases bone mass in osteoporosis. RANKL inhibition decreases tumor-induced bone destruction and SREs. Denosumab is indicated for prevention of SREs in patients with multiple myeloma.

Daratumumab (Darzalex)

Monoclonal antibody that binds with high affinity to the CD38 molecule, which is highly expressed on the surface of multiple myeloma cells. It is indicated for patients with multiple myeloma who have received at least 3 prior treatments, including a proteasome inhibitor (PI) and an immunomodulatory agent (IMiD), or who are double-refractory to a PI and IMiD. Other regimens for relapsed/refractory MM are approved for daratumumab in combination with dexamethasone plus bortezomib or lenalidomide or pomalidomide. It is also indicated for newly diagnosed MM in patients ineligible for ASCT as part of various combination regimens. May also be consider in newly diagnosed MM in patients who are eligible for ASCT in combination with bortezomib, thalidomide, and dexamethasone.

Elotuzumab (Empliciti)

Humanized IgG1 monoclonal antibody that specifically targets the SLAMF7 (signaling lymphocytic activation molecule family member 7) protein. SLAMF7 is expressed on myeloma cells and natural killer cells and plasma cells. Facilitates the interaction with natural killer cells to mediate the killing of myeloma cells through antibody-dependent cellular cytotoxicity. It is indicated in combination with lenalidomide and dexamethasone for multiple myeloma in patients who have received 1-3 prior therapies. Elotuzumab is also indicated in combination with pomalidomide and dexamethasone for patients with multiple myeloma who have received 2 or more prior therapies including lenalidomide and a proteasome inhibitor.

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