Takeda Yusuke, Sakaida Emiko, Nakaseko Chiaki
Nihon Rinsho. 2015 Jan;73(1):130-6.
In the past decade, the introduction of bortezomib, thalidomide, and lenalidomide has changed the treatment of multiple myeloma (MM) dramatically. Combinations of bortezomib or lenalidomide with dexamethasone have improved response rates and prolonged response duration compared with older approaches. However, many patients will relapse, and efforts to improve survival are still needed. Several clinical studies have demonstrated that bortezomib- or lenalidomide-based triplet regimens have improved activity compared with doublet regimens. Bortezomib and lenalidomide have different but overlapping mechanisms of anti-MM activity in preclinical studies. In several studies, the triplet regimens of lenalidomide, bortezomib, and dexamethasone (RVD) have shown significant efficacy and favorable tolerability in both newly diagnosed and relapsed/refractory multiple myeloma. In this review, we will focus on RVD therapy for myeloma treatment.
在过去十年中,硼替佐米、沙利度胺和来那度胺的引入极大地改变了多发性骨髓瘤(MM)的治疗方式。与传统治疗方法相比,硼替佐米或来那度胺与地塞米松联合使用提高了缓解率并延长了缓解持续时间。然而,许多患者会复发,仍需努力提高生存率。多项临床研究表明,与双联方案相比,基于硼替佐米或来那度胺的三联方案具有更高的活性。在临床前研究中,硼替佐米和来那度胺具有不同但相互重叠的抗MM活性机制。在多项研究中,来那度胺、硼替佐米和地塞米松(RVD)三联方案在新诊断和复发/难治性多发性骨髓瘤中均显示出显著疗效和良好耐受性。在本综述中,我们将重点关注RVD疗法在骨髓瘤治疗中的应用。