肿瘤细胞治疗研究
英文原题：Novel drug combinations for newly diagnosed multiple myeloma: how can we improve on current regimens?
对 NDMM 患者而言，确定最佳治疗顺序是一项挑战。
过去十年，多发性骨髓瘤（MM）治疗发生显著进展。免疫调节剂和抗CD38抗体重塑了治疗格局，但疾病仍会复发，且每次复发后预后进一步恶化。因此，在一线治疗中获得深度应答对于降低未来疾病负荷至关重要。本综述旨在评估现有疗法，并探讨通过整合新型药物组合及生物标志物指导的治疗，如何改善新诊断多发性骨髓瘤（NDMM）患者的疗效和耐受性。综述纳入荟萃分析、系统综述、原始研究及真实世界研究，检索PubMed、Scopus和Google Scholar数据库，时间自建库至2025年2月。专家观点：为NDMM患者确定最佳治疗顺序仍具挑战。微小残留病灶评估正成为指导治疗策略、改善结局和耐受性的关键工具。新证据支持早期使用强效疗法（如新一代抗CD38抗体和CELMoD药物），以获得更深且更持久的缓解，并可能延迟复发。双特异性抗体和CAR-T等免疫疗法也正在前线治疗中探索，但如何减少其感染并发症仍在研究中。
INTRODUCTION: Multiple myeloma (MM) therapy has greatly evolved over the last decade. Immunomodulators and anti-CD38 antibodies have reshaped the therapeutic landscape. Nevertheless, relapses occur with worsening prognosis each relapse. Achieving deep responses in first-line treatment is key to reducing future disease burden. AREAS COVERED: To advance patient outcomes, current regimens must be continuously refined through personalization, incorporation of biomarkers to guide therapy, and novel drugs. This review aims to assess existing therapies and investigate how integrating novel drug combinations and biomarker-driven approaches can improve efficacy and tolerability for newly diagnosed multiple myeloma (NDMM) patients. Meta-analysis, systematic reviews, original articles, and real-world studies were included in this review. Databases searched included PubMed, Scopus, and Google Scholar from inception until February 2025. EXPERT OPINION: Discerning the best therapy sequence is a challenge for NDMM individuals. Minimal residual disease assessment is becoming a pivotal tool for guiding therapeutic approaches to enhance outcomes and tolerability. Emerging evidence supports early use of potent therapies - such as next-generation anti-CD38 antibodies and CELMoDs - to achieve deeper, more durable responses and possibly delay relapses. Immunotherapies like bispecific antibodies and CAR-T cells are also being explored in front-line settings, though reducing their infectious complications is still under investigation.
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