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治疗复发性多发性骨髓瘤的新靶点。

Novel targets for the treatment of relapsing multiple myeloma.

机构信息

a Department of Medicine and Surgery , University of Parma , Parma , Italy.

b Department of Medical Science , University of Turin , Turin , Italy.

出版信息

Expert Rev Hematol. 2019 Jul;12(7):481-496. doi: 10.1080/17474086.2019.1624158. Epub 2019 Jun 3.

Abstract

: Multiple myeloma (MM) is characterized by the high tendency to relapse and develop drug resistance. : This review focused on the main novel targets identified to design drugs for the treatment of relapsing MM patients. CD38 and SLAMF7 are the main surface molecules leading to the development of monoclonal antibodies (mAbs) recently approved for the treatment of relapsing MM patients. B cell maturation antigen (BCMA) is a suitable target for antibody-drug conjugates, bispecific T cell engager mAbs and Chimeric Antigen Receptor (CAR)-T cells. Moreover, the programmed cell death protein 1 (PD)-1/PD-Ligand (PD-L1) expression profile by MM cells and their microenvironment and the use of immune checkpoints inhibitors in MM patients are reported. Finally, the role of histone deacetylase (HDAC), B cell lymphoma (BCL)-2 family proteins and the nuclear transport protein exportin 1 (XPO1) as novel targets are also underlined. The clinical results of the new inhibitors in relapsing MM patients are discussed. : CD38, SLAMF7, and BCMA are the main targets for different immunotherapeutic approaches. Selective inhibitors of HDAC6, BCL-2, and XPO1 are new promising compounds under clinical investigation in relapsing MM patients.

摘要

多发性骨髓瘤(MM)的特征是高复发和耐药倾向。本文重点介绍了为治疗复发性 MM 患者而设计药物的主要新型靶点。CD38 和 SLAMF7 是最近被批准用于治疗复发性 MM 患者的单克隆抗体(mAbs)发展的主要表面分子。B 细胞成熟抗原(BCMA)是抗体药物偶联物、双特异性 T 细胞衔接 mAbs 和嵌合抗原受体(CAR)-T 细胞的合适靶标。此外,还报告了 MM 细胞及其微环境中程序性细胞死亡蛋白 1(PD)-1/PD 配体(PD-L1)的表达谱,以及免疫检查点抑制剂在 MM 患者中的应用。最后,还强调了组蛋白去乙酰化酶(HDAC)、B 细胞淋巴瘤(BCL)-2 家族蛋白和核转运蛋白输出蛋白 1(XPO1)作为新型靶点的作用。讨论了新抑制剂在复发性 MM 患者中的临床结果。CD38、SLAMF7 和 BCMA 是不同免疫治疗方法的主要靶点。HDAC6、BCL-2 和 XPO1 的选择性抑制剂是复发性 MM 患者临床研究中具有前景的新型化合物。

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