Division of Hematology, Department of Medicine, Stanford University, Stanford, CA, USA.
Stanford Cancer Institute, Stanford, CA, USA.
Curr Hematol Malig Rep. 2021 Apr;16(2):183-191. doi: 10.1007/s11899-021-00624-6. Epub 2021 Mar 17.
The field of multiple myeloma treatment has entered a new era with antibody-based approaches in clinical practice. In this review, we focus on the clinical approaches of utilizing antibody-based modality, specifically monoclonal antibodies, antibody-drug conjugates, and bispecific T-cell antibodies in the treatment of multiple myeloma.
Three monoclonal antibodies (daratumumab, isatuximab, elotuzumab) and one anti-BCMA (B-cell maturation antigen) antibody-drug conjugate (belantamab mafodotin) have been approved by the FDA in the last 5 years for the treatment of multiple myeloma. There are many ongoing clinical trials using novel targets and constructs, including bispecific antibodies against BCMA, GPRC5D, and FCRH5. In addition to exploring efficacy, there are ongoing efforts to overcome the resistance to therapy. Antibody-based therapy has improved the outcomes of patients with multiple myeloma and has been incorporated in the standard of care. We expect to see novel targets and constructs that can achieve a deeper and more durable response while minimizing toxicity, as well as better strategies for toxicity management for existing agents. We also expect that antibody-based strategies will be used in earlier lines of therapy in the future.
随着抗体类药物在临床实践中的应用，多发性骨髓瘤的治疗领域已经进入了一个新时代。在这篇综述中，我们重点关注利用抗体类药物（特别是单克隆抗体、抗体药物偶联物和双特异性 T 细胞抗体）治疗多发性骨髓瘤的临床方法。
在过去的 5 年里，美国食品药品监督管理局（FDA）已经批准了三种单克隆抗体（达雷妥尤单抗、伊沙妥昔单抗、埃罗妥珠单抗）和一种抗 B 细胞成熟抗原（BCMA）抗体药物偶联物（贝兰他单抗马妥珠单抗）用于多发性骨髓瘤的治疗。目前有许多正在进行的临床试验，涉及新型靶点和构建体，包括针对 BCMA、GPRC5D 和 FCRH5 的双特异性抗体。除了探索疗效外，目前还在努力克服治疗耐药性。抗体类药物治疗改善了多发性骨髓瘤患者的预后，并已纳入标准治疗方案。我们期望看到能够实现更深层次和更持久反应的新型靶点和构建体，同时最大限度地降低毒性，以及更好的现有药物毒性管理策略。我们还期望在未来的治疗中更早地使用抗体类药物治疗策略。
