肿瘤细胞治疗研究
英文原题：30 Years of Improved Survival in Non-Transplant-Eligible Newly Diagnosed Multiple Myeloma.
过去几年间，多发性骨髓瘤（MM）的治疗已取得巨大进展。
过去几年多发性骨髓瘤（MM）治疗大幅进步，老年患者（现称不适合移植患者，NTE）也从新疗法中获益。自20世纪60年代起，化疗数十年来是唯一治疗方式；2000年代免疫调节剂（沙利度胺、来那度胺、泊马度胺）及蛋白酶体抑制剂（硼替佐米、卡非佐米、伊沙佐米）问世，开启延长生存的第一步。随后单克隆抗体成为适合移植和不适合移植患者治疗的重要里程碑。抗CD38单抗可安全用于老年患者，与来那度胺和地塞米松三联产生显著疗效，达到此前未有的生存水平。未来NTE患者仍可能从新近进入MM治疗领域的免疫疗法获益，如CAR-T及双特异性抗体；这些免疫治疗的“升级版本”可能改善疗效，但仍需研究明确其在这一人群中的作用。
The treatment of multiple myeloma (MM) has greatly evolved these past few years. Recent advances in therapeutics have largely benefited elderly patients now renamed "non-transplant-eligible" (NTE) patients. Since the 1960s, and for several decades, chemotherapy was the only treatment for MM. Then, the field was marked by the emergence of targeted therapies in the 2000s, such as immunomodulating agents (thalidomide, lenalidomide, and pomalidomide) and proteasome inhibitors (bortezomib, carfilzomib, and ixazomib), which were the first steps towards an increase in survival. Thereafter, the apparition of monoclonal antibodies (mAbs) was considered a milestone in the treatment of MM for both transplant-eligible and NTE patients. Anti-CD38 mAbs can be safely administered to older patients with an impressive efficacy leading to a never-achieved-before survival rate with the triple association of anti-CD38 mAbs, lenalidomide, and dexamethasone. However, progress is still expected with the introduction in the armamentarium for NTE patients of the most recent innovative immunotherapy-based treatments newly introduced in MM, e.g., CAR-T cells and bispecific antibodies. These "improved versions" of immune-based treatments will probably also benefit NTE patients, although further studies will be needed to better understand their role in this population.
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