Ahn Inhye E, Mailankody Sham, Korde Neha, Landgren Ola
Inhye Ahn and Sham Mailankody, the National Cancer Institute, National Institutes of Health, Bethesda, MD; Neha Korde and Ola Landgren, Memorial Sloan Kettering Cancer Center, New York, NY.
J Clin Oncol. 2015 Jan 1;33(1):115-23. doi: 10.1200/JCO.2014.56.4351. Epub 2014 Nov 24.
Novel therapies hold promise for high-risk smoldering multiple myeloma (SMM). Recent studies suggest that modern combination approaches can be options for high-risk SMM to obtain deep molecular responses with favorable toxicity profiles. Although pioneering treatment trials based on small numbers of patients suggest progression-free and overall survival benefits, application of the data to real-life practice remains to be validated. Therapeutic modulation of disease tempo, disease burden, clonal evolution, and tumor microenvironment in SMM remains to be understood and calls for reliable biomarkers reflective of disease biology. Here, we review studies that open a new management platform for SMM, address ongoing dilemmas in practice and under investigation, and highlight emerging scientific questions in the era of SMM treatment.
新型疗法为高危冒烟型多发性骨髓瘤(SMM)带来了希望。最近的研究表明,现代联合治疗方法可作为高危SMM的选择,以获得具有良好毒性特征的深度分子反应。尽管基于少数患者的开创性治疗试验显示出无进展生存期和总生存期的益处,但将这些数据应用于实际临床仍有待验证。对SMM中疾病进展速度、疾病负担、克隆进化和肿瘤微环境的治疗性调控仍有待了解,并且需要反映疾病生物学特征的可靠生物标志物。在此,我们回顾了一些研究,这些研究为SMM开辟了一个新的管理平台,解决了当前临床实践中以及正在研究中的困境,并突出了SMM治疗时代新出现的科学问题。