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重新定义多发性骨髓瘤治疗:免疫治疗的进展、挑战和未来方向

英文原题:Redefining multiple myeloma treatment: Advances, challenges, and future directions in immunotherapy.

查看英文原题

Redefining multiple myeloma treatment: Advances, challenges, and future directions in immunotherapy.

PubMed 2025/08/08(内容时间) Chin Med J (Engl) Q1 · IF 9.1(JCR 2025)

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中文摘要

多发性骨髓瘤(MM)是一种血液系统恶性肿瘤,其异质性以及复发和进展倾向给治疗带来重大挑战。过去20年间,MM治疗格局发生了巨大变化,但该病在很大程度上仍无法治愈,许多患者面临治疗耐药。本综述评估了当前MM治疗现状,重点讨论传统疗法的局限,以及免疫治疗在改善患者结局方面正在发挥的作用。文章强调,实现并维持微小残留病灶阴性及免疫反应平衡,是重要治疗目标。此外,综述讨论了正在改善患者前景的免疫治疗进展,尤其针对复发/难治性疾病。CAR-T 细胞疗法、双特异性抗体和双特异性T细胞衔接器等创新策略,通过靶向恶性细胞和骨髓微环境,显示出显著潜力;这两者都是疾病持续存在和治疗耐药的重要因素。未来研究应着重优化MM治疗策略,包括将免疫治疗整合进更早线治疗,以及开发个体化治疗所需的预测性生物标志物,最终改善患者结局。

展开英文摘要原文

Multiple myeloma (MM) is a hematological malignancy that poses significant treatment challenges due to its heterogeneity and propensity for relapse and progression. In the last two decades, the therapeutic landscape of MM has changed dramatically, but the disease remains largely incurable, with many patients facing treatment resistance.

This review evaluates the current status of MM treatments, emphasizing the limitations of traditional therapies and the emerging role of immunotherapy in improving patient outcomes. It highlights the importance of achieving and maintaining minimal residual disease negativity and a balanced immune response as key treatment goals.

Furthermore, it discusses the advancements in immunotherapies that are improving the prospects for patients, particularly those with relapsed or refractory disease. Innovative strategies, such as chimeric antigen receptor T-cell therapy, bispecific antibodies, and bispecific T cell engagers, have shown significant promise by targeting the malignant cells and the bone marrow microenvironment, which are essential for disease persistence and resistance to therapy.

Future research should focus on refining MM treatment strategies, including the integration of immunotherapy into earlier treatment lines and the development of predictive biomarkers for personalized treatment approaches, ultimately enhancing patient outcomes.

论文信息

作者
Fu C、Zhai Y、Yan L、Jin S、Shang J、Shi X、Wu D
单位
National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215000, China.China
文献类型
综述
期刊
Chinese medical journal2025 Oct 5
原文标识
PubMed 40784898 · DOI 10.1097/CM9.0000000000003655