Cancer J. 2021;27(2):112-118. doi: 10.1097/PPO.0000000000000506.
Despite improvements in effective therapy, multiple myeloma remains incurable, and virtually all patients will face relapsed disease at some point after diagnosis. The prognosis for relapsed myeloma after developing resistance to anti-CD38 monoclonal antibodies, proteasome inhibitors, immunomodulatory agents, and autologous stem cell transplantation has been poor; however, the development of immune effector cell therapy with chimeric antigen receptor (CAR) T cells may dramatically improve the outlook for patients, although none of these therapies are approved for MM to date. Herein, we review the development and history of CAR T-cell therapy for multiple myeloma, mechanisms of resistance, and strategies to improve outcomes with CAR T therapy.
尽管有效治疗有所改善,但多发性骨髓瘤仍然无法治愈,几乎所有患者在诊断后都会在某个时候面临疾病复发。在对抗 CD38 单克隆抗体、蛋白酶体抑制剂、免疫调节剂和自体干细胞移植产生耐药后,多发性骨髓瘤复发的预后较差;然而,嵌合抗原受体 (CAR) T 细胞的免疫效应细胞治疗的发展可能会极大地改善患者的前景,尽管迄今为止尚无这些疗法被批准用于 MM。在此,我们回顾了 CAR T 细胞治疗多发性骨髓瘤的发展和历史、耐药机制以及通过 CAR T 治疗改善结局的策略。