Mina Roberto, Cerrato Chiara, Bernardini Annalisa, Aghemo Elena, Palumbo Antonio
a Myeloma Unit , University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino , Torino , Italy.
Expert Opin Pharmacother. 2016;17(2):181-92. doi: 10.1517/14656566.2016.1115016. Epub 2015 Dec 18.
Novel agents and the availability of autologous stem-cell transplantation have revolutionized the treatment of patients with multiple myeloma. First-generation novel agents namely thalidomide, lenalidomide, and bortezomib have significantly improved response and survival of patients. Second-generation novel agents such as pomalidomide, carfilzomib, and monoclonal antibodies are being tested both in the newly diagnosed and relapse settings, and results are promising.
In this review article, the main results derived from Phase III trials with thalidomide, lenalidomide, and bortezomib for the treatment of myeloma patients, both at diagnosis and at relapse, are summarized. Data about second-generation novel agents such as pomalidomide and carfilzomib are also reported. Newer effective drugs currently under investigation and the promising results with monoclonal antibodies are described.
The availability of new effective drugs has considerably increased the treatment options for myeloma patients. A sequential approach including induction, transplantation (when possible), consolidation, and maintenance is an optimal strategy to achieve disease control and prolong survival. Despite these improvements, the best combination, the optimal sequence, and the proper target of newer drugs need to be defined.
新型药物和自体干细胞移植的可及性彻底改变了多发性骨髓瘤患者的治疗方式。第一代新型药物，即沙利度胺、来那度胺和硼替佐米，显著改善了患者的缓解率和生存率。第二代新型药物，如泊马度胺、卡非佐米和单克隆抗体，正在新诊断和复发情况下进行测试，结果令人期待。
在这篇综述文章中，总结了沙利度胺、来那度胺和硼替佐米用于治疗骨髓瘤患者（包括诊断时和复发时）的III期试验的主要结果。还报告了关于第二代新型药物如泊马度胺和卡非佐米的数据。描述了目前正在研究的更新的有效药物以及单克隆抗体的令人期待的结果。
新型有效药物的可及性大大增加了骨髓瘤患者的治疗选择。包括诱导、移植（若可能）、巩固和维持的序贯方法是实现疾病控制和延长生存期的最佳策略。尽管有这些进展，但仍需要确定更新药物的最佳组合、最佳顺序和合适靶点。
