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多发性骨髓瘤治疗中免疫疗法的最新进展。

Current developments in immunotherapy in the treatment of multiple myeloma.

机构信息

Department of Hematology, Oncology, and Stem Cell Transplantation, Department of Medicine I, University Medical Center Freiburg, Freiburg, Germany.

Comprehensive Cancer Center Freiburg, University Medical Center Freiburg, Freiburg, Germany.

出版信息

Cancer. 2018 May 15;124(10):2075-2085. doi: 10.1002/cncr.31243. Epub 2018 Feb 6.

Abstract

Multiple myeloma (MM) is the second most common hematologic malignancy and represents approximately 10% of all hematological neoplasms. Standard therapy consists of induction therapy followed by high-dose chemotherapy and autologous stem cell transplantation (ASCT) or, if ASCT cannot be performed, standard doublet, triplet, or quadruplet, novel agent-containing induction treatment until progression. Although MM is still regarded as mostly incurable by current standards, the development of several novel compounds, combination therapies, and immunotherapy approaches has raised great hopes about transforming MM into an indolent, chronic disease and possibly achieving a cure for individual patients. Several new inhibitory and immunological agents have been approved or are under intensive investigation and may lead to new therapeutic options for patients with relapsed/refractory MM, for patients ineligible for ASCT, and for patients after ASCT. Especially in the field of immunotherapy, including monoclonal antibodies, checkpoint inhibition, and chimeric antigen receptor T cells, current advances are rapid and highly promising. This review aims to summarize the newest and most promising immunotherapeutic agents for MM, their clinical efficacy, their adverse event (AE) profiles, and the ways in which these AEs can best be overcome or avoided. Cancer 2018;124:2075-85. © 2018 American Cancer Society.

摘要

多发性骨髓瘤(MM)是第二常见的血液系统恶性肿瘤,约占所有血液系统肿瘤的 10%。标准治疗包括诱导治疗,随后是大剂量化疗和自体干细胞移植(ASCT),或者如果不能进行 ASCT,则进行标准的双药、三药、四药联合,新型药物诱导治疗,直到进展。尽管多发性骨髓瘤目前仍被认为是不可治愈的,但几种新型化合物、联合治疗和免疫治疗方法的发展,使人们对将多发性骨髓瘤转化为惰性、慢性疾病,并有可能为个别患者治愈疾病抱有很大的希望。几种新的抑制性和免疫性药物已经获得批准或正在进行密集研究,可能为复发/难治性多发性骨髓瘤患者、不适合进行 ASCT 的患者和 ASCT 后的患者提供新的治疗选择。特别是在免疫治疗领域,包括单克隆抗体、检查点抑制和嵌合抗原受体 T 细胞,目前的进展非常迅速,前景非常广阔。本文旨在总结多发性骨髓瘤最新、最有前途的免疫治疗药物,及其临床疗效、不良事件(AE)谱,以及如何最好地克服或避免这些 AE。癌症 2018;124:2075-85。©2018 美国癌症协会。

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