Defining Multiple Myeloma as a Target for DNA Vaccines

New therapies in multiple myeloma (MM) now achieve disease remission in the majority of cases and open the possibility of immunotherapeutic intervention during the stage of minimal residual disease. Active vaccination provides considerable scope in this setting, and our focus has been on developing DNA vaccines to induce anti-tumour immunity. These DNA vaccines offer a flexibility of design to engage multiple arms of the immune response, with delivery of fusion genes to augment immunity to weak antigens and bypass tolerogenic pressure exerted by tumour cells, which are notable in MM. DNA vaccines have progressed from preclinical studies to clinical trials, as in MM. Disease-specific considerations include the nature of the cell “feeding” tumour growth in order to define relevant antigens, immune status and effects of therapy, clinical regimens to induce remission and how these taken together impact on effective use of DNA vaccines as immunotherapy in MM.