肿瘤细胞治疗研究
英文原题:Tailoring Therapy for Frail and Elderly Myeloma Patients.
Tailoring Therapy for Frail and Elderly Myeloma Patients.
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多发性骨髓瘤是一种浆细胞恶性肿瘤,其临床结局具有异质性。大多数患者在七十多岁时被诊断,且常伴有与年龄相关的合并症和器官功能障碍。随着针对 CD38、BCMA 和 GPRC5D 的免疫疗法的引入,包括单克隆抗体、双特异性抗体和嵌合抗原受体(CAR)T 细胞疗法,骨髓瘤的治疗格局正在迅速演变。这些新型疗法带来了更深、更持久的缓解,并提出了功能性治愈或彻底治愈的可能性。然而,老年和体弱患者仍然面临较差的结局、更高的毒性发生率和显著的脱失率,这代表着一个重大的未被满足的临床挑战。
Multiple myeloma is a plasma cell malignancy associated with heterogeneous clinical outcomes. The majority of patients are diagnosed during their seventh decade and often present with age-related comorbidities and organ dysfunction.
Myeloma therapeutic landscape is rapidly evolving with the introduction of immune-based therapies, including monoclonal and bispecific antibodies and chimeric antigen receptor (CAR) T-cell therapies targeting CD38, BCMA, and GPRC5D. These novel therapies have led to deeper and more durable responses and have raised the possibility of functional or definitive cure.
However, older and frail patients continue to experience poorer outcomes, higher toxicity rates, and substantial treatment attrition, representing a major unmet clinical challenge. In this review, we discuss current approaches to the assessment and management of frailty in patients with multiple myeloma, with a focus on optimizing frontline therapy and treatment at relapse in the era of the possible achievement of a cure.
We highlight emerging data on cellular therapies in this population and the importance of individualized, goal-directed treatment strategies aimed at balancing efficacy, tolerability, and quality of life.
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