Department of Hematology, University of Leuven and Leuven Cancer Institute, Leuven, Belgium.
Department of Regeneration and Development, University of Leuven, Leuven, Belgium.
Expert Rev Hematol. 2021 Apr;14(4):365-376. doi: 10.1080/17474086.2021.1905513. Epub 2021 Mar 31.
: Impressive therapeutic progress is being made in the management of multiple myeloma (MM). his progress is related to the introduction of several new classes of therapeutic agents including proteasome inhibitors, immunomodulatory drugs (IMiDs) and monoclonal antibodies (MoAbs).: In this manuscript, the role of the IMiDs thalidomide and lenalidomide in the management of newly diagnosed MM is discussed. The mode of action of IMiDs and their role in the management of newly diagnosed MM patients is highlighted. In addition, clinical data on how MoAbs such as the anti-CD38 antibody daratumumab can further increase the efficacy of IMiD-based first-line anti-myeloma regimens are provided. A database search in PubMed was carried out.: Immunomodulation has become an indispensable part of successful anti-myeloma regimens both at relapse and at diagnosis. The combination of lenalidomide plus dexamethasone with an anti-CD38 MoAb such as daratumumab and a proteasome inhibitor such as bortezomib is currently one of the most potent first-line treatment regimens for MM. A better understanding on how IMiDs synergize with existing and new anti-myeloma treatments can further improve the outcome for patients. Optimal first-line therapy will continue to benefit the long-term outcome of a growing population of young and elderly MM patients.
在多发性骨髓瘤（MM）的治疗方面取得了令人瞩目的进展。这一进展与几种新的治疗药物类别的引入有关，包括蛋白酶体抑制剂、免疫调节药物（IMiDs）和单克隆抗体（MoAbs）。本文讨论了 IMiDs 沙利度胺和来那度胺在新诊断 MM 中的治疗作用。强调了 IMiDs 的作用模式及其在新诊断 MM 患者治疗中的作用。此外，还提供了 MoAbs（如抗 CD38 抗体达鲁单抗）如何进一步提高基于 IMiD 的一线抗骨髓瘤方案疗效的临床数据。在 PubMed 中进行了数据库检索。免疫调节已成为复发和诊断时成功抗骨髓瘤方案不可或缺的一部分。来那度胺联合地塞米松与达鲁单抗和硼替佐米等蛋白酶体抑制剂联合使用的方案是目前最有效的 MM 一线治疗方案之一。更好地了解 IMiDs 如何与现有和新的抗骨髓瘤治疗协同作用，可进一步改善患者的预后。最佳的一线治疗将继续有益于越来越多的年轻和老年 MM 患者的长期预后。
