The ELOQUENT-2 clinical study showed improved objective response rates and improved overall survival in patients with refractory relapsed multiple myeloma treated with the combination of elotuzumab and lenalidomide compared to those treated with elotuzumab alone. However, the mechanisms by which the combination improves disease control have not been resolved. The study by Richardson and colleagues revealed for the first time the mechanisms through which elotuzumab and lenalidomide treatment acts, involving complex interactions between myeloma cells, natural killer cells and monocytes.

Graft-versus-host disease (GvHD) of the gastrointestinal (GI) tract is a major driver of morbidity and mortality after allogeneic hematopoietic stem cell transplantation (HSCT). At the same time alterations in intestinal microbiota composition are reproducibly observed in HSCT with an attendant loss of diversity and a shift from anaerobes to facultative aerobes. Chhabra and colleagues present results of a phase II study in which tocilizumab was administered as adjunctive GvHD prophylaxis to patients at high risk of developing GI-tract disease to assess its effect on transplant outcomes and microbial diversity and composition. They conclude that an extended course of tocilizumab is effective at preventing lower GI-tract GvHD, and that loss of microbial diversity and enterococcal domination is attenuated in tocilizumab-treated recipients.