Siegel David S
Chief of the Division of Multiple Myeloma, John Theurer Cancer Center, Hackensack University Medical Center, 92 Second Street, 3rd Floor, Hackensack, NJ 07601, USA.
Ther Adv Hematol. 2013 Dec;4(6):354-65. doi: 10.1177/2040620713511176.
Multiple myeloma is characterized by periods of remission followed by relapse, and eventually the disease becomes refractory to treatment. While patients with multiple myeloma frequently receive multiple lines of treatment, antimyeloma agents are associated with a number of toxicities that can impact their use and influence future treatment options. Patients with relapsed and/or refractory multiple myeloma are particularly challenging to treat due to the advanced state of their disease, typically greater resistance to treatment, and the presence of disease- and treatment-related comorbidities. An understanding of the safety profile of the therapeutic agents used in treating multiple myeloma is thus crucial for appropriate patient management. Single-agent carfilzomib has been approved in the United States for the treatment of patients with relapsed and refractory multiple myeloma, and has been shown to be efficacious and well-tolerated in this setting. This review examines the frequency of common and significant hematologic and nonhematologic adverse events following administration of single-agent carfilzomib in four phase II trials in relapsed and/or refractory multiple myeloma, and provides practical recommendations for their management.
多发性骨髓瘤的特点是缓解期与复发期交替出现，最终疾病会变得对治疗难治。虽然多发性骨髓瘤患者经常接受多线治疗，但抗骨髓瘤药物会带来多种毒性，这些毒性会影响其使用并影响未来的治疗选择。复发和/或难治性多发性骨髓瘤患者由于疾病进展、通常对治疗的更大耐药性以及存在与疾病和治疗相关的合并症，治疗起来特别具有挑战性。因此，了解用于治疗多发性骨髓瘤的治疗药物的安全性概况对于恰当的患者管理至关重要。单药卡非佐米已在美国获批用于治疗复发和难治性多发性骨髓瘤患者，并且在这种情况下已显示出有效且耐受性良好。本综述考察了在四项复发和/或难治性多发性骨髓瘤II期试验中给予单药卡非佐米后常见和严重血液学及非血液学不良事件的发生频率，并为其管理提供实用建议。
