Multiple myeloma is a cancer where the neoplastic cells maintain a function like plasma cells, meaning they produce monoclonal antibodies. The cancer affects the body in several ways including often reduced kidney function, bone and fractures, as well as anemia and hypercalcemia.
The mainstay of treatment is chemotherapy, immunomodulatory drugs and proteasome inhibitors. Patients fit enough undergo high dose chemotherapy with autologous stem cell support. Despite treatment advances in the recent years, multiple myeloma is still a largely incurable disease. The five-year overall survival is 43%.
We have developed a vaccine against an immunoinhibitory molecule called PD-L1. PD-L1 is exploited by various cancers to inhibit T-cell mediated immune destruction of the cancer. Multiple myeloma also exploits this mechanism by upregulating PD-L1. The level of upregulation of PD-L1 is associated with the prognosis of the patient, more PD-L1 upregulation associated with worse prognosis.
In this project we will test PD-L1 peptides first-in-man in patients with multiple myeloma, who have received high dose chemotherapy and stem cell support. We will include 10 patients from the department of Hematology, Herlev Hospital. Endpoints are toxicity and immune responses. Clinical effects will be described.
UPDATE November 2017: Active, not recruiting
(Clinicaltrials.gov ID NCT03042793)