Genadieva Stavric Sonja, Bonello Francesca, Bringhen Sara, Boccadoro Mario, Larocca Alessandra
a Medical Faculty , University Hematology Clinic , Skopje , Macedonia.
b Myeloma Unit, Division of Hematology , University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino , Torino , Italy.
Expert Rev Hematol. 2017 Jun;10(6):551-561. doi: 10.1080/17474086.2017.1326814. Epub 2017 May 19.
Treatment of multiple myeloma has undergone profound changes in the past years thanks to the increased understanding of the biology of the disease and the new treatment options. New drugs and effective approaches are currently available for the treatment of multiple myeloma, including immunomodulatory agents, proteasome inhibitors and autologous stem cell transplantation. Areas covered: We have described the recent updated criteria to start treatment in multiple myeloma and summarized clinical data from major studies including most recent agents. Particularly, results with pomalidomide, carfilzomib, ixazomib, monoclonal antibodies such as elotuzumab, daratumumab, and checkpoint inhibitors have been reported. Both transplant and non-transplant settings have been covered. Expert commentary: Despite the successful improvement in overall survival and time to relapse, multiple myeloma still remains incurable. Therefore, there is still an unmet need for new treatment strategies with novel mechanisms of action, like monoclonal antibodies, novel immunomodulators, and novel proteasome inhibitors. Implementation of these novel drugs in rationally designed therapies with a good balance of efficacy and safety should be carefully considered in order to improve outcome.
在过去几年中，由于对多发性骨髓瘤疾病生物学的深入了解以及新的治疗选择，多发性骨髓瘤的治疗发生了深刻变化。目前有新药和有效方法可用于治疗多发性骨髓瘤，包括免疫调节剂、蛋白酶体抑制剂和自体干细胞移植。涵盖领域：我们描述了近期更新的多发性骨髓瘤开始治疗的标准，并总结了包括最新药物在内的主要研究的临床数据。特别是，已报道了泊马度胺、卡非佐米、伊沙佐米、单抗如埃罗妥珠单抗、达雷妥尤单抗以及检查点抑制剂的治疗结果。移植和非移植治疗方案均有涉及。专家评论：尽管在总生存期和复发时间方面取得了成功改善，但多发性骨髓瘤仍然无法治愈。因此，对于具有新作用机制的新治疗策略，如单克隆抗体、新型免疫调节剂和新型蛋白酶体抑制剂，仍存在未满足的需求。为了改善治疗结果，应仔细考虑将这些新药合理地应用于疗效和安全性良好平衡的治疗方案中。
