Hematology Department, University Hospital of Salamanca, Salamanca, Spain.
Expert Rev Hematol. 2008 Oct;1(1):17-28. doi: 10.1586/17474086.1.1.17.
Although multiple myeloma remains an incurable disease, its management has changed recently with the introduction of novel agents, including bortezomib. Several pilot studies and two randomized trials have evaluated the role of bortezomib-based combinations as induction therapy in myeloma patients who are candidates for transplant, showing high efficacy (>80% response rate with 20-30% complete remission), which increased after autologous stem cell transplant. In addition, in patients who are not candidates for transplant, bortezomib in combination with melphalan and prednisone has also been found to be superior to conventional therapy, with high overall and complete response rates; responses were rapid and durable and there was a significant prolongation in time to progression and overall survival. Moreover, bortezomib has broad utility since its efficacy is not influenced by the presence of poor prognostic features, such as high-risk cytogenetic abnormalities, renal impairment or advanced age. These results allow bortezomib-based combination therapy to be established as key options for patients with previously untreated multiple myeloma.
虽然多发性骨髓瘤仍然是一种无法治愈的疾病，但随着新型药物（包括硼替佐米）的引入，其治疗方法最近发生了变化。几项试点研究和两项随机试验评估了硼替佐米为基础的联合治疗方案作为移植候选患者诱导治疗的作用，显示出高疗效（>80%的缓解率，20-30%的完全缓解率），在自体干细胞移植后增加。此外，在不适合移植的患者中，硼替佐米联合美法仑和泼尼松也被发现优于传统疗法，具有较高的总缓解率和完全缓解率；反应迅速且持久，疾病进展时间和总生存期显著延长。此外，由于硼替佐米的疗效不受不良预后特征（如高危细胞遗传学异常、肾功能损害或高龄）的影响，因此具有广泛的应用。这些结果使得硼替佐米为基础的联合治疗方案成为未经治疗的多发性骨髓瘤患者的重要选择。
