Malignancy: Idiotypic Immune Targeting of Multiple Myeloma

Immunotherapy of malignant diseases remains a major therapeutic challenge. In multiple myeloma, interests have been focussed primarily on the targeting of the idiotypic protein since it represents one of the few tumor specific antigens. Various vaccination strategies have been employed, including the use of naked protein, protein conjugated to Keyhole Limpet Hemocyanin and, most recently, vaccine delivered via dendritic cells. Studies so far indicate the feasibility of inducing potentially beneficial idiotype-specific immune responses in the autologous hosts. However, the antitumor responses produced by the vaccines have been generally modest and sup-optimal. Further work is therefore ongoing to optimize the antitumor responses by including cytokines in the vaccination schedule. In addition, the development of a polyvalent vaccine is also being explored. The next few years should prove interesting and crucial in bringing effective and reliable immunotherapeutic strategies to the clinics.