Boussi Leora, Niesvizky Ruben
Division of Hematology and Medical Oncology, Multiple Myeloma Center, New York City, New York, USA.
Curr Opin Oncol. 2017 Nov;29(6):460-466. doi: 10.1097/CCO.0000000000000407.
Here, we explore the significant progress made in the treatment of multiple myeloma, focusing on immunotherapy and the promise it has offered to patients suffering from advanced disease.
Multiple myeloma, a B-cell malignancy, is characterized by unregulated plasma cell growth in the bone marrow as well as strong immunosuppression in the tumor microenvironment. mAbs targeting tumor antigens overcome this, increasing T-cell activation, multiple myeloma cell death, and depth of response. Similarly, adoptive T-cell therapy aims to engineer or isolate tumor-specific T cells for a targeted approach. Finally, peptide and dendritic cell/tumor fusion vaccines reeducate the immune system, expanding the immune response and generating long-term memory to prevent relapse of disease. Many of these approaches have been combined with existing therapies to enhance antitumor immunity.
Immunotherapeutic approaches have remarkably changed the treatment paradigm for multiple myeloma, and encouraging patient responses have warranted further investigation into mAbs, adoptive T-cell therapy, vaccines, and combination therapy.
在此，我们探讨多发性骨髓瘤治疗方面取得的重大进展，重点关注免疫疗法及其为晚期疾病患者带来的希望。
多发性骨髓瘤是一种B细胞恶性肿瘤，其特征是骨髓中浆细胞生长失控以及肿瘤微环境中的强烈免疫抑制。靶向肿瘤抗原的单克隆抗体克服了这一问题，增强了T细胞活化、多发性骨髓瘤细胞死亡以及反应深度。同样，过继性T细胞疗法旨在改造或分离肿瘤特异性T细胞以实现靶向治疗。最后，肽和树突状细胞/肿瘤融合疫苗重塑免疫系统，扩大免疫反应并产生长期记忆以预防疾病复发。其中许多方法已与现有疗法相结合以增强抗肿瘤免疫力。
免疫治疗方法显著改变了多发性骨髓瘤的治疗模式，令人鼓舞的患者反应值得对单克隆抗体、过继性T细胞疗法、疫苗及联合疗法进行进一步研究。
