多发性骨髓瘤中的单克隆抗体疗法:开发新靶点面临的挑战

Monoclonal Antibody Therapies in Multiple Myeloma: A Challenge to Develop Novel Targets.

作者信息

Nishida Hiroko, Yamada Taketo

机构信息

Department of Pathology, Keio University, School of Medicine, Tokyo 160-8582, Japan.

Department of Pathology, Saitama Medical University, Faculty of Medicine, Saitama 350-0495, Japan.

出版信息

J Oncol. 2019 Nov 3;2019:6084012. doi: 10.1155/2019/6084012. eCollection 2019.

Abstract

The treatment options in multiple myeloma (MM) has changed dramatically over the past decade with the development of novel agents such as proteasome inhibitors (PIs); bortezomib and immunomodulatory drugs (IMiDs); thalidomide, and lenalidomide which revealed high efficacy and improvement of overall survival (OS) in MM patients. However, despite these progresses, most patients relapse and become eventually refractory to these therapies. Thus, the development of novel, targeted immunotherapies has been pursued aggressively. Recently, next-generation PIs; carfilzomib and ixazomib, IMiD; pomalidomide, histone deacetylase inhibitor (HDADi); panobinostat and monoclonal antibodies (MoAbs); and elotuzumab and daratumumab have emerged, and especially, combination of mAbs plus novel agents has led to dramatic improvements in the outcome of MM patients. The field of immune therapies has been accelerating in the treatment of hematological malignancies and has also taken center stage in MM. This review focuses on an overview of current status of novel MoAb therapy including bispecific T-cell engager (BiTE) antibody (BsAb), antibody-drug conjugate (ADC), and chimeric antigen receptor (CAR) T cells, in relapsed or refractory MM (RRMM). Lastly, investigational novel MoAb-based therapy to overcome immunotherapy resistance in MM is shown.

摘要

在过去十年中,随着蛋白酶体抑制剂(PIs)硼替佐米等新型药物以及免疫调节剂(IMiDs)沙利度胺和来那度胺的出现,多发性骨髓瘤(MM)的治疗选择发生了巨大变化,这些药物在MM患者中显示出高效性并改善了总生存期(OS)。然而,尽管取得了这些进展,大多数患者仍会复发并最终对这些疗法产生耐药性。因此,新型靶向免疫疗法的研发一直在积极推进。最近,新一代PIs卡非佐米和伊沙佐米、IMiD泊马度胺、组蛋白去乙酰化酶抑制剂(HDACi)帕比司他以及单克隆抗体(MoAbs)埃罗妥珠单抗和达雷妥尤单抗相继出现,尤其是单克隆抗体与新型药物的联合使用显著改善了MM患者的治疗效果。免疫疗法领域在血液系统恶性肿瘤的治疗中发展迅速,在MM治疗中也占据了中心地位。本综述重点概述了复发或难治性MM(RRMM)中新型单克隆抗体疗法的现状,包括双特异性T细胞衔接器(BiTE)抗体(BsAb)、抗体药物偶联物(ADC)和嵌合抗原受体(CAR)T细胞。最后,展示了用于克服MM免疫疗法耐药性的新型基于单克隆抗体的研究性疗法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/22c1/6875016/f2bb26681026/JO2019-6084012.001.jpg

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