Dana-Farber Cancer Institute, Boston, MA 02215, USA.
Hematology Am Soc Hematol Educ Program. 2011;2011:184-90. doi: 10.1182/asheducation-2011.1.184.
Patient outcome in multiple myeloma (MM) has been remarkably improved due to the use of combination therapies including proteasome inhibitors and immunomodulatory drugs, which target the tumor in its BM microenvironment. Ongoing efforts to improve the treatment paradigm even further include using oncogenomics to better characterize molecular pathogenesis and to develop refined patient stratification and personalized medicine in MM; using models of MM in its BM milieu to identify novel targets and to validate next-generation therapeutics directed at these targets; developing immune-based therapies including mAbs, immunotoxins targeting MM cells and cytokines, and novel vaccine strategies; and using functional oncogenomics to inform the design of novel combination therapies. With continued rapid evolution of progress in these areas, MM will be a chronic illness with sustained complete response in a significant number of patients.
由于包括蛋白酶体抑制剂和免疫调节剂在内的联合疗法的应用,多发性骨髓瘤(MM)患者的预后得到了显著改善,这些药物靶向肿瘤在骨髓微环境中的作用。目前,为了进一步改善治疗模式,正在努力利用肿瘤基因组学更好地描述分子发病机制,并开发用于 MM 的精细化患者分层和个性化医疗;利用 MM 在骨髓环境中的模型来确定新的靶点,并验证针对这些靶点的下一代治疗药物;开发基于免疫的治疗方法,包括针对 MM 细胞的单克隆抗体、免疫毒素和细胞因子,以及新型疫苗策略;并利用功能肿瘤基因组学来为新型联合治疗方案的设计提供信息。随着这些领域的快速发展,多发性骨髓瘤将成为一种慢性疾病,使大量患者获得持续完全缓解。