University Hospital Hotel-Dieu, Nantes, France.
Istituto Seragnoli, Bologna, Italy.
Blood Cancer J. 2019 Mar 20;9(4):38. doi: 10.1038/s41408-019-0200-1.
Over the last years, there has been great progress in the treatment of multiple myeloma with many new agents and combinations having been approved and being now routinely incorporated into treatment strategies. As a result, patients are experiencing benefits in terms of survival and better tolerance. However, the multitude of treatment options also presents a challenge to select the best options tailored to the specific patient situation. Lenalidomide is increasingly being used as part of frontline therapy in newly diagnosed multiple myeloma. This agent is typically administered until disease progression. It is currently unclear, how to best manage patients, who relapse while receiving lenalidomide as part of their frontline treatment. We conducted a review to summarize the available evidence in this setting. Our summary shows that there are very few data from current trials testing new combinations based on carfilzomib, pomalidomide, or daratumumab that address this specific patient population. Our review is aimed to summarize the available evidence to assist treatment decision making and to raise awareness of this lack of data to encourage further analyses and the incorporation of sequencing questions in future trial designs.
在过去的几年中，多发性骨髓瘤的治疗取得了很大的进展，许多新的药物和联合方案已经获得批准，并被常规纳入治疗策略。因此，患者在生存和更好的耐受性方面都受益。然而，大量的治疗选择也给选择最适合特定患者情况的最佳方案带来了挑战。来那度胺越来越多地被用作新诊断多发性骨髓瘤一线治疗的一部分。该药物通常在疾病进展前使用。目前尚不清楚如何最好地管理在接受来那度胺作为一线治疗时发生疾病复发的患者。我们进行了一项综述，以总结这一背景下的现有证据。我们的综述表明，目前几乎没有来自临床试验的数据，这些数据测试了基于卡非佐米、泊马度胺或达雷妥尤单抗的新组合，这些数据针对这一特定患者群体。我们的综述旨在总结现有证据，以协助治疗决策，并提高对这一缺乏数据的认识，以鼓励进一步分析和在未来试验设计中纳入测序问题。
