Tufts Medical Center, Boston, MA, USA.
Dana Farber Cancer Institute, Harvard Medical School, Jerome Lipper Multiple Myeloma Center, Boston, MA, USA.
Br J Haematol. 2018 May;181(4):447-459. doi: 10.1111/bjh.15121. Epub 2018 Apr 25.
Multiple myeloma (MM) is the second most common haematological malignancy after non-Hodgkin lymphoma. Despite the improvement in outcomes over the last decade with the introduction of novel therapies, such as immunomodulatory agents (IMiDs) and proteasome inhibitors (PIs), MM remains an incurable disease. Patients who are both refractory to IMiDs and PIs carry a particularly dismal prognosis. The development of targeted therapy in the form of monoclonal antibodies has shifted the treatment paradigm of this disease, resulting in unprecedented response rates, even among the highest-risk patients. In this review, we will summarize the mechanism of action and provide an overview of the clinical trials that have led to the US Food and Drug Administration approval of Daratumumab and Elotuzumab, and their current use in the treatment of MM.
多发性骨髓瘤(MM)是仅次于非霍奇金淋巴瘤的第二大常见血液系统恶性肿瘤。尽管在过去十年中随着新型疗法(如免疫调节剂(IMiDs)和蛋白酶体抑制剂(PIs))的引入,其治疗效果有所改善,但 MM 仍然是一种不可治愈的疾病。对 IMiDs 和 PIs 均耐药的患者预后尤其差。以单克隆抗体为形式的靶向治疗的发展改变了这种疾病的治疗模式,导致了前所未有的反应率,甚至在最高危患者中也是如此。在这篇综述中,我们将总结其作用机制,并概述导致达妥木单抗和埃罗妥珠单抗获得美国食品和药物管理局批准的临床试验及其目前在 MM 治疗中的应用。