Department of Medicine, Division of Oncology, University of Maryland Medical Center , Baltimore, MD, USA.
Expert Rev Hematol. 2020 Jun;13(6):669-686. doi: 10.1080/17474086.2020.1756258. Epub 2020 Apr 27.
As we have just stepped into a new decade of hopes, the mountain of knowledge learned from multiple myeloma (MM) remains unmatched among cancers. In the last decade alone, this rapid-sequence learning curve has led to regulatory approvals of eight drugs with mechanisms of actions representing five different areas of cell biology some of which made to the frontline setting, sparking debates about how to best sequence them in the treatment continuum of induction, consolidation, and maintenance and gained momentum with the realization of the implications of an effective upfront therapeutic approach with potential impact on survival.
This review was written with an intent to introduce the reader to the current treatment approach of a newly diagnosed myeloma patient and acquaint with promising targets and mechanistic strategies. Medline and clinicaltrials.gov databases (2000-2020) and relevant meetings (ASH, ASCO, EHA, ESMO, IMW) reports were queried and guidelines (IMWG) were reviewed to distill to expert opinion in an inundating field.
Future holds promise with new targets on the horizon. It is likely that the new age of myeloma will belong to quadruplets with the addition of acellular or cellular biologics to first-generation novel agents, leading to new paradigms.
当我们刚刚迈入新的十年的希望之际，从多发性骨髓瘤（MM）中学到的知识之山在癌症中仍然无与伦比。仅在过去十年中，这种快速学习曲线就导致了八种具有五种不同细胞生物学作用机制的药物获得监管批准，其中一些药物已成为一线治疗方案，引发了关于如何在诱导、巩固和维持治疗连续体中最佳地对其进行排序的争论，并随着认识到有效的一线治疗方法的意义而获得了动力，这种方法有可能对生存产生影响。
本综述的目的是向读者介绍新诊断骨髓瘤患者的当前治疗方法，并了解有前途的靶点和机制策略。检索了 Medline 和 clinicaltrials.gov 数据库（2000-2020 年）和相关会议（ASH、ASCO、EHA、ESMO、IMW）报告，并审查了指南（IMWG），以从泛滥的领域中提炼出专家意见。
未来充满希望，新的靶点即将出现。骨髓瘤的新时代很可能属于四联体，第一代新型药物加上无细胞或细胞生物制剂，将带来新的范例。
