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多发性骨髓瘤治疗的最新进展:简要综述

英文原题:Recent advances in the treatment of multiple myeloma: a brief review.

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Recent advances in the treatment of multiple myeloma: a brief review.

PubMed 2022/09/29(内容时间) Fac Rev

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中文摘要

多发性骨髓瘤近期治疗史以重大进展为标志,现有治疗最终改善了患者生存。以抗CD38单克隆抗体为代表的免疫疗法,获益覆盖所有患者群体,可能是迄今骨髓瘤领域最重大的进步。在免疫治疗疗效基础上,CAR-T 细胞或双特异性抗体等“现代”免疫疗法正在开发中。这些新型免疫疗法显然备受期待;尽管最初用于复发性骨髓瘤,它们无疑将挑战当前较早治疗线的策略。自抗CD38疗法发展以来,免疫治疗已成为骨髓瘤治疗里程碑,并带来许多范式转变。尽管如此,骨髓瘤仍无法治愈,仍需多样化治疗选择,尤其是大量接受既往治疗的患者。此前促成大多数治疗成功的非免疫疗法也不应完全放弃。过去几年揭示了新的病理生理机制,进而发现新靶点,推动新药和新药物类别开发,例如XPO1抑制剂和抗BCL-2药物。总之,多发性骨髓瘤未来充满可能,未来几年治疗顺序仍有望发生显著变化。

展开英文摘要原文

The recent history of multiple myeloma has been marked by tremendous advances in the treatments available, which have ultimately improved the patients' survival. Immune-based therapies, starting with the emergence of anti-CD38 monoclonal antibodies, whose impact is seen across all groups of patients, are probably the greatest evolution in the field of myeloma so far. Building on the efficacy of immunotherapy, "modern" immunological treatments such as CAR-T cells or bispecific antibodies are being developed. There clearly are lots of expectations for these novel immunotherapies, and, though first developed in relapsed myeloma, they will surely challenge the current strategies in early lines of treatment.

Immunotherapy, since the development of anti-CD38, is a milestone in the treatment of myeloma and has already led to many paradigm shifts. Nevertheless, myeloma remains an incurable disease and diversified options are still required, notably for heavily pretreated patients.

Non-immune-based treatments, which were responsible for most successes previously, are not to be completely abandoned. Novel pathophysiological mechanisms have been unraveled in the past few years, and thus, new targets have been identified, leading to the development of new drugs and new drug classes, such as XPO1 inhibitors and anti-BCL-2.

Overall, the future of multiple myeloma is full of possibilities and considerable changes are still expected in the sequencing of treatments in the years to come.

论文信息

作者
Bobin A、Leleu X
单位
Department of Hematology, University Hospital of Poitiers, 2 rue de la Milétrie, CHU de Poitiers, Poitiers, France.France
文献类型
综述
期刊
Faculty reviews2022
原文标识
PubMed 36225211 · DOI 10.12703/r/11-28