Padda Jaskamal, Khalid Khizer, Zubair Ujala, Peethala Mounika M, Kakani Varsha, Goriparthi Lakshmi, Almanie Abdulelah H, Cooper Ayden Charlene, Jean-Charles Gutteridge
Internal Medicine, JC Medical Center, Orlando, USA.
Internal Medicine, Avalon University School of Medicine, Willemstad, CUW.
Cureus. 2021 Jun 25;13(6):e15917. doi: 10.7759/cureus.15917. eCollection 2021 Jun.
Multiple myeloma (MM) has a five-year prevalence worldwide of 230,000 people and is known as the second most common hematological malignancy within the United States. Extensive research has been conducted to gain a wide range of treatment strategies, providing hope to these patients. Combination therapy using chemotherapy, monoclonal antibodies, and immunomodulatory drugs are the current management of choice. After the introduction of chimeric antigen receptor (CAR) T cell therapy, promising results have been evidenced. In this therapy, T cells are derived from the patient and modified in-vitro to induce receptors that later target specific antigens when they are injected into patients. CAR T cells use three mechanisms to kill tumor cells: cytolytic pathways, cytokine release, and Fas/FasL axis. In this review, we highlight the different tumor markers targeted for therapy against multiple myeloma (MM). Target antigens for CAR T cell therapy include B-cell maturation antigen (BCMA), signaling lymphocyte activation molecule F7 (SLAMF7), CD38, CD138, CD19, immunoglobulin kappa light chain, orphan G protein-coupled receptor class C group 5 member D (GPRC5D). With the benefit of improving survival and prognosis, this therapy does carry a risk of some adverse events such as cytokine release syndrome, encephalopathy, infections, hypogammaglobulinemia, and tumor lysis syndrome.
多发性骨髓瘤（MM）在全球的五年患病率为23万人，在美国它是第二常见的血液系统恶性肿瘤。人们已经进行了广泛的研究以获得多种治疗策略，为这些患者带来了希望。使用化疗、单克隆抗体和免疫调节药物的联合疗法是目前的首选治疗方法。嵌合抗原受体（CAR）T细胞疗法引入后，已取得了令人鼓舞的结果。在这种疗法中，T细胞取自患者并在体外进行改造，以诱导产生受体，这些受体在注入患者体内后会靶向特定抗原。CAR T细胞通过三种机制杀死肿瘤细胞：细胞溶解途径、细胞因子释放和Fas/FasL轴。在本综述中，我们重点介绍了针对多发性骨髓瘤（MM）治疗的不同肿瘤标志物。CAR T细胞疗法的靶抗原包括B细胞成熟抗原（BCMA）、信号淋巴细胞激活分子F7（SLAMF7）、CD38、CD138、CD19、免疫球蛋白κ轻链、孤儿G蛋白偶联受体C类第5组成员D（GPRC5D）。尽管这种疗法有助于提高生存率和改善预后，但它确实存在一些不良事件的风险，如细胞因子释放综合征、脑病、感染、低丙种球蛋白血症和肿瘤溶解综合征。
