Mazumder Amitabha, Jagannath Sundar
New York Medical College, St Vincent's Comprehensive Cancer Center, 325 West 15th Street, New York, NY 10011, USA.
Best Pract Res Clin Haematol. 2006;19(4):769-80. doi: 10.1016/j.beha.2006.06.006.
Multiple myeloma is a treatable but not necessarily a curable plasma-cell cancer. After decades of minimal progress, two new classes of drugs with novel mechanisms of action - immunomodulatory drugs (thalidomide and lenalidomide) and proteasome inhibitors (bortezomib) - have been introduced for the treatment of this disease. Thalidomide and lenalidomide have shown great activity as single agents and in combination with glucocorticoids for the treatment of chemotherapy-refractory myeloma. Thalidomide - and more recently lenalidomide - in combination with dexamethasone have shown promising results as induction therapy. These drugs can easily be combined with other chemotherapeutic agents to potentiate the anti-myeloma effect. The immunomodulatory function of these drugs can be successfully exploited to control residual disease during remission. Thus, both thalidomide and lenalidomide have ushered in a new era of optimism in the management of this incurable cancer.
多发性骨髓瘤是一种可治疗但不一定能治愈的浆细胞癌。在经历了数十年进展甚微的情况后，两类具有全新作用机制的新型药物——免疫调节药物（沙利度胺和来那度胺）和蛋白酶体抑制剂（硼替佐米）——已被用于治疗这种疾病。沙利度胺和来那度胺作为单一药物以及与糖皮质激素联合使用时，对化疗难治性骨髓瘤的治疗均显示出强大活性。沙利度胺——以及最近的来那度胺——与地塞米松联合作为诱导治疗已显示出有前景的结果。这些药物能够轻易地与其他化疗药物联合使用以增强抗骨髓瘤效果。这些药物的免疫调节功能可被成功利用以在缓解期控制残留疾病。因此，沙利度胺和来那度胺都为这种无法治愈的癌症的治疗带来了一个新的乐观时代。
