Raje Noopur, Hideshima Teru, Anderson Kenneth C
Division of Hematology and Oncology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA.
Expert Rev Anticancer Ther. 2006 Sep;6(9):1239-47. doi: 10.1586/14737140.6.9.1239.
Immunomodulatory drugs, such as thalidomide, lenalidomide (Revlimid, CC-5013) and actimid (CC-4047), have a broad spectrum of activity and have shown remarkable responses in patients with multiple myeloma and related hematological diseases, such as myelodysplastic syndrome. They are currently being tested in other cancer types. This review will focus on the preclinical and clinical activity of thalidomide and its more potent immunomodulatory derivatives that are used to treat multiple myeloma. They represent a new class of antitumor agents that not only target the tumor cell directly, but also have significant activity within the bone marrow milieu. These agents have shown high responses in all phases of multiple myeloma, including the upfront setting, relapsed refractory stage and also as maintenance therapy for the disease. They have been used in combination with dexamethasone, chemotherapy and, more recently, with other novel agents, such as proteasome inhibitors. Thalidomide and lenalidomide in combination with dexamethasone have recently been approved by the US FDA for the treatment of multiple myeloma.
免疫调节药物，如沙利度胺、来那度胺（瑞复美，CC - 5013）和阿地米德（CC - 4047），具有广泛的活性，在多发性骨髓瘤及相关血液系统疾病（如骨髓增生异常综合征）患者中已显示出显著疗效。目前它们正在其他癌症类型中进行试验。本综述将聚焦于沙利度胺及其更有效的用于治疗多发性骨髓瘤的免疫调节衍生物的临床前和临床活性。它们代表了一类新型抗肿瘤药物，不仅直接靶向肿瘤细胞，而且在骨髓微环境中也具有显著活性。这些药物在多发性骨髓瘤的各个阶段都显示出高缓解率，包括初始治疗阶段、复发难治阶段以及作为该疾病的维持治疗。它们已与地塞米松、化疗药物联合使用，最近还与其他新型药物（如蛋白酶体抑制剂）联合使用。沙利度胺和来那度胺与地塞米松联合使用最近已获美国食品药品监督管理局批准用于治疗多发性骨髓瘤。
