CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题：Treating Multiple Myeloma in the Context of the Bone Marrow Microenvironment.
Treating Multiple Myeloma in the Context of the Bone Marrow Microenvironment.
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多发性骨髓瘤（MM）的治疗格局已发生显著演变，过去二十年间至少有15种药物获得FDA批准。这些新型疗法联合自体干细胞移植的使用，为MM患者带来了显著的生存获益。特别是，我们对骨髓（BM）和免疫微环境理解的加深，促进了高效免疫疗法的发展，这些疗法即使在多药难治性疾病背景下也展现出前所未有的缓解率。然而，MM的治疗仍然具有挑战性，尤其是在高危情况下。MM治疗耐药的一个关键介质是骨髓（BM）微环境；需要更深入的理解以促进针对BM微环境中MM的疗法开发，从而引发更深层、更持久的缓解，最终目标是长期控制或治愈MM。在这篇综述中，我们讨论了目前对BM微环境在MM发病机制中所起作用的理解，重点关注其免疫抑制性质。我们还回顾了目前临床使用的FDA批准免疫疗法，并重点介绍了即将出现的有前景的免疫治疗策略。
The treatment landscape of multiple myeloma (MM) has evolved considerably with the FDA-approval of at least 15 drugs over the past two decades.
Together with the use of autologous stem cell transplantation, these novel therapies have resulted in significant survival benefit for patients with MM. In particular, our improved understanding of the BM and immune microenvironment has led to the development of highly effective immunotherapies that have demonstrated unprecedented response rates even in the multiple refractory disease setting.
However, MM remains challenging to treat especially in a high-risk setting. A key mediator of therapeutic resistance in MM is the bone marrow (BM) microenvironment; a deeper understanding is necessary to facilitate the development of therapies that target MM in the context of the BM milieu to elicit deeper and more durable responses with the ultimate goal of long-term control or a cure of MM. In this review, we discuss our current understanding of the role the BM microenvironment plays in MM pathogenesis, with a focus on its immunosuppressive nature.
We also review FDA-approved immunotherapies currently in clinical use and highlight promising immunotherapeutic approaches on the horizon.
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