Elotuzumab for treating myeloma

Introduction: Multiple myeloma remains an incurable disease; the introduction of novel drugs has improved outcomes but patients become eventually refractory. Areas covered: Monoclonal antibodies targeting multiple myeloma-related antigens can complement currently available therapies. SLAMF7, a cell surface glycoprotein receptor that is a member of the signaling lymphocytic activation molecule (SLAM) family, is highly and nearly uniformly expressed in myeloma cells and Natural Killer (NK) cells, but is not detected on normal solid tissues or on hematopoietic stem cells. Elotuzumab is a humanized IgG1 monoclonal antibody targeting SLAMF7. It has been shown to be effective in preclinical studies and in the clinical setting, although only stabilization of the disease was reported when used as a single-agent. Its combination with antimyeloma therapies was positive and several trials have confirmed this hypothesis. The results of these trials in terms of efficacy and safety will be covered in this review. Expert opinion: Elotuzumab, plus lenalidomide and dexamethasone, is the first immunostimulatory monoclonal antibody demonstrating a benefit in progression free survival in a large phase 3 study in patients with relapsed or relapsed and refractory disease, representing a new standard of care for this patient population.