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Oncolytic Viruses in Multiple Myeloma Treatment

Introduction to Multiple Myeloma

Multiple myeloma (MM) is one of the commonest types of blood cancer which accounts for 1% of all cancers and approximately 10% of all hematologic malignancies. Like all cancers, factors that cause multiple myeloma are complex and poorly defined, including but not limited to exposure to organic chemicals, toxins, ionizing radiation. Genetic predisposition is also observed but the condition is not usually inherited. Non-specific symptoms of fatigue, loss of appetite, and weight loss are very common. Bone pain, back pain, and pathological fracture may also occur. Diagnosis of multiple myeloma is often completed through numerous methods, including but not limited to blood count, biochemistry analysis, paraprotein detection, and bone marrow examination.

Treatment for Multiple Myeloma

Currently, there is no cure for multiple myeloma. However, some treatments can help ease the pain, reduce complications, and slow the progression of the disease. Pharmacological therapy and autologous hematopoietic stem cell transplant (AHSCT) are usually used for the treatment of multiple myeloma. Three classes of drugs usually used include immunomodulatory agents, proteasome inhibitors and monoclonal antibodies. The immunomodulatory drugs lenalidomide and pomalidomide are thought to alter the tumor microenvironment in a manner that promotes MM cell killing by the immune system in addition to having anti-proliferative and anti-angiogenic effects. Proteasome inhibitors, such as bortezomib and carfilzomib, induce apoptotic death by preventing the normal turnover of cellular proteins. Cells that produce large quantities of protein, such as malignant plasma cells, are particularly sensitive to the effects of proteasome inhibition. Combination therapy with these drugs has significantly improved patient survival time. Lenalidomide and bortezomib in combination with the corticosteroid dexamethasone is currently the treatment of choice for the initial presentation of MM.

Primary mechanisms of tumor specificity for oncolytic virotherapy in multiple myeloma. Fig.1 Primary mechanisms of tumor specificity for oncolytic virotherapy in multiple myeloma. (Calton, 2018)

Oncolytic Viral Therapy for Multiple Myeloma

Reference

  1. Calton, C.M.; et al. Oncolytic viruses for multiple myeloma therapy. Cancers. 2018, 10(6), p.198.

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