Panminerva medica
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Recent advances in treatment modalities have led to improved survival in patients with multiple myeloma (MM). However, despite these, MM remains an incurable disease. Many MM patients relapse through and become refractory to current treatment strategies or are intolerant due to toxicities arising from therapy. ⋯ Given the high expression of BCMA in malignant Plasma cells compared to those from normal healthy volunteers, targeting BCMA should reduce risks of on-target off-tumor toxicities. The main BCMA-targeting approaches currently used for treatment of MM include: 1) chimeric antigen receptor (CAR) T-cell therapy; 2) bi- and multi- specific antibodies; and 3) monoclonal antibodies and their drug conjugates. This review will outline these therapeutic agents and present their emerging clinical data.
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The Coronavirus disease 2019 (COVID-19) pandemic, caused by symptomatic severe acute respiratory syndrome-Coronavirus-2 (SARS-CoV-2) infection, has wreaked havoc globally, challenging the healthcare, economical, technological and social status quo of developing but also developed countries. For instance, the COVID-19 scare has reduced timely hospital admissions for ST-elevation myocardial infarction in Europe and the USA, causing unnecessary deaths and disabilities. While the emergency is still ongoing, enough efforts have been put to study and tackle this condition such that a comprehensive perspective and synthesis on the potential role of breakthrough healthcare technologies is possible. Indeed, current state-of-the-art information technologies can provide a unique opportunity to adapt and adjust to the current healthcare needs associated with COVID-19, either directly or indirectly, and in particular those of cardiovascular patients and practitioners. ⋯ We are confident that refinement and command of smartcare technologies will prove extremely beneficial in the short-term, but also dramatically reshape cardiovascular practice and healthcare delivery in the long-term future, for COVID-19 as well as other diseases.
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Treatment of multiple myeloma (MM) patients has radically changed over the last years following the introduction of next generation proteasome inhibitors (PI) and immunomodulatory derivative (IMiDs). In the last years, one further therapeutic option for MM patients is represented by monoclonal antibodies (MoAbs), that seem to change the paradigm of MM treatment, particularly for heavily pretreated or double refractory to a PI and IMiDs patients. Antibodies have an immune-based mechanism, induce durable responses with limited toxicity and combine well with existing therapies. ⋯ Immunotherapeutic strategies offer a new and exciting approach to target key molecular pathways that continue to be implicated in the survival of malignant plasma cells. These targets include cell surface proteins (CD38, CD138 [SDC1], B cell maturation antigen [BCMA, TNFRSF17]), cytokines that play a role in plasma cell survival and proliferation (interleukin 6 [IL6] and B cell activating factor), signal regulators of bone metabolism (RANKL [TNFSF11], DKK1) and regulators of the immune system (PD-1[PDCD1], PD-L1[CD274]). This article focuses on new MoAbs and related innovative immunotherapeutic modalities currently under investigation in the treatment landscape of MM.