多发性骨髓瘤治疗的最新进展:简要回顾。

Faculty reviews Pub Date : 2022-09-29 eCollection Date: 2022-01-01 DOI:10.12703/r/11-28
Arthur Bobin, Xavier Leleu
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引用次数: 2

摘要

近年来,多发性骨髓瘤的治疗方法取得了巨大的进步,最终提高了患者的生存率。以抗cd38单克隆抗体的出现为起点的免疫治疗可能是迄今为止骨髓瘤领域最大的进步,其影响在所有患者群体中都可以看到。基于免疫疗法的疗效,诸如CAR-T细胞或双特异性抗体等“现代”免疫疗法正在开发中。显然,人们对这些新的免疫疗法有很多期待,尽管它们最初是在复发性骨髓瘤中开发的,但它们肯定会在早期治疗中挑战当前的策略。免疫疗法,自从抗cd38的发展以来,是骨髓瘤治疗的一个里程碑,并且已经导致了许多范式的转变。然而,骨髓瘤仍然是一种无法治愈的疾病,仍然需要多样化的选择,特别是对大量预处理的患者。以前取得大多数成功的非免疫治疗不能完全放弃。在过去的几年里,新的病理生理机制已经被揭示,从而发现了新的靶点,导致了新的药物和新的药物类别的开发,如XPO1抑制剂和抗bcl -2。总的来说,多发性骨髓瘤的未来充满了可能性,未来几年的治疗顺序仍有望发生重大变化。
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Recent advances in the treatment of multiple myeloma: a brief review.

The recent history of multiple myeloma has been marked by tremendous advances in the treatments available, which have ultimately improved the patients' survival. Immune-based therapies, starting with the emergence of anti-CD38 monoclonal antibodies, whose impact is seen across all groups of patients, are probably the greatest evolution in the field of myeloma so far. Building on the efficacy of immunotherapy, "modern" immunological treatments such as CAR-T cells or bispecific antibodies are being developed. There clearly are lots of expectations for these novel immunotherapies, and, though first developed in relapsed myeloma, they will surely challenge the current strategies in early lines of treatment. Immunotherapy, since the development of anti-CD38, is a milestone in the treatment of myeloma and has already led to many paradigm shifts. Nevertheless, myeloma remains an incurable disease and diversified options are still required, notably for heavily pretreated patients. Non-immune-based treatments, which were responsible for most successes previously, are not to be completely abandoned. Novel pathophysiological mechanisms have been unraveled in the past few years, and thus, new targets have been identified, leading to the development of new drugs and new drug classes, such as XPO1 inhibitors and anti-BCL-2. Overall, the future of multiple myeloma is full of possibilities and considerable changes are still expected in the sequencing of treatments in the years to come.

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