Rabin N, Lai M, Pratt G, Morgan G, Snowden J, Bird J, Cook G, Bowcock S, Owen R, Yong K, Wechalaker A, Low E, Davies F
Department of Haematology, University College London Hospitals, London, UK.
Int J Lab Hematol. 2014 Dec;36(6):665-75. doi: 10.1111/ijlh.12205. Epub 2014 Mar 27.
Therapeutic advances and the availability of novel agents have significantly improved outcomes in myeloma; yet, it remains incurable and strategies to improve survival continue to be sought. One approach is to prolong the duration of response and increase progression-free survival (PFS) through consolidation or maintenance treatment with regimens that have low toxicity profiles, and do not negatively impact on quality of life. Data from several studies with thalidomide, lenalidomide and bortezomib consistently show improvements in response and PFS, although results have still to be confirmed with respect to overall survival (OS). Despite the promising data, the optimal use of consolidation and maintenance treatment in terms of regimen, dose and duration has yet to be defined. Given the evidence to date, the UK Myeloma Forum believes that both maintenance and consolidation therapy should be considered as treatment options for patients with myeloma. Patients should be encouraged to enrol in clinical studies. This document reviews the current position of maintenance and consolidation for patients with myeloma treated in the UK.
治疗进展和新型药物的出现显著改善了骨髓瘤的治疗效果；然而，该病仍无法治愈，人们仍在不断探索提高生存率的策略。一种方法是通过使用毒性较低且不负面影响生活质量的方案进行巩固或维持治疗，从而延长缓解期并提高无进展生存期（PFS）。多项使用沙利度胺、来那度胺和硼替佐米的研究数据一致显示，缓解率和无进展生存期有所改善，尽管总生存期（OS）的结果仍有待证实。尽管有这些有前景的数据，但在方案、剂量和疗程方面巩固和维持治疗的最佳用法尚未确定。鉴于目前的证据，英国骨髓瘤论坛认为维持和巩固治疗都应被视为骨髓瘤患者的治疗选择。应鼓励患者参加临床研究。本文回顾了英国骨髓瘤患者维持和巩固治疗的现状。
