Holánek M, Hájek R
Interní hematoonkologická klinika, Fakultní nemocnice Brno, Jihlavska 20, 625 00 Brno.
Klin Onkol. 2010;23(2):67-72.
Lenalidomide is a promising new drug in the treatment of patients with multiple myeloma. The analogue of thalidomide was created with the intention of improving the anticancer activity, its immunomodulatory properties as well as reducing the toxicity of the preparation. The mechanism of antitumor action of the preparation appears to be the effect on cells, tumour microenvironment and in particular the regulation of cytokinine production. Performed clinical studies Phase I and II have shown efficacy in patients with relapsed multiple myeloma. Subsequently, large randomized trials demonstrated the benefit of combined therapy in relapsed/refractory multiple myeloma patients with a combination of lenalidomide plus dexamethasone compared with dexamethasone treatment alone. Patients treated with a combination of lenalidomide and dexamethasone had significantly higher therapeutic response and overall survival than patients treated with dexamethasone alone. Profound toxicity seems to be the myelosuppressive effect of lenalidomide. The work gives a summary of the information available on lenalidomide in the treatment of multiple myeloma.
来那度胺是治疗多发性骨髓瘤患者的一种有前景的新药。它是沙利度胺的类似物，旨在提高抗癌活性、免疫调节特性以及降低制剂的毒性。该制剂的抗肿瘤作用机制似乎是对细胞、肿瘤微环境的影响，特别是对细胞因子产生的调节。已进行的I期和II期临床研究表明其对复发的多发性骨髓瘤患者有效。随后，大型随机试验证明，与单独使用地塞米松治疗相比，来那度胺联合地塞米松的联合疗法对复发/难治性多发性骨髓瘤患者有益。接受来那度胺和地塞米松联合治疗的患者比单独接受地塞米松治疗的患者具有显著更高的治疗反应和总生存期。来那度胺的严重毒性似乎是骨髓抑制作用。本文总结了来那度胺治疗多发性骨髓瘤的现有信息。
