Richardson Paul G, Mitsiades Constantine, Schlossman Robert, Ghobrial Irene, Hideshima Teru, Munshi Nikhil, Anderson Kenneth C
Dana-Farber Cancer Institute, 44 Binney Street, Dana 1B02, Boston, MA 02115, USA.
Expert Rev Anticancer Ther. 2008 Jul;8(7):1053-72. doi: 10.1586/14737140.8.7.1053.
Front-line therapy for multiple myeloma is rapidly evolving with the development of new, highly active regimens based on novel agents such as bortezomib. Bortezomib-based regimens are demonstrating substantial efficacy both as induction prior to stem cell transplantation and as treatment for patients ineligible for transplant, offering rapid and durable responses with consistently high rates of complete response, a surrogate end point for improved overall survival. Combinations of bortezomib plus established and novel agents, such as melphalan-prednisone, dexamethasone, doxorubicin, thalidomide-dexamethasone and, most recently, lenalidomide-dexamethasone, are proving superior to or more promising than previous standards of care. Importantly, these regimens are demonstrating enhanced activity across the front-line population, including patients with renal impairment, high-risk cytogenetics and advanced bone disease. Impressive Phase 3 results with bortezomib-melphalan-prednisone, bortezomib-dexamethasone and bortezomib-thalidomide-dexamethasone should facilitate the establishment of these highly effective regimens as key therapies for newly diagnosed myeloma.
随着基于硼替佐米等新型药物的新型高效治疗方案的发展，多发性骨髓瘤的一线治疗正在迅速演变。基于硼替佐米的治疗方案在干细胞移植前诱导治疗以及不适于移植的患者治疗中均显示出显著疗效，能带来快速且持久的反应，完全缓解率持续保持在较高水平，而完全缓解是改善总生存期的替代终点。硼替佐米与已有的及新型药物联合使用，如美法仑 - 泼尼松、地塞米松、阿霉素、沙利度胺 - 地塞米松，以及最近的来那度胺 - 地塞米松，已证明优于或比以往的标准治疗更具前景。重要的是，这些治疗方案在包括肾功能损害、高危细胞遗传学和晚期骨病患者在内的一线人群中均显示出增强的活性。硼替佐米 - 美法仑 - 泼尼松、硼替佐米 - 地塞米松和硼替佐米 - 沙利度胺 - 地塞米松令人印象深刻的3期试验结果，应有助于确立这些高效治疗方案作为新诊断骨髓瘤的关键治疗方法。
