Department of Hematology, Loudi Gereral Hospital, Loudi Hunan 417000.
Department of Hematology, Third Xiangya Hospital, Central South University, Changsha 410013, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2021 Aug 28;46(8):900-908. doi: 10.11817/j.issn.1672-7347.2021.200430.
Multiple myeloma (MM) is a highly heterogeneous malignant plasma cell disease. Proteasome inhibitors (PIs) are the first line of medicine for MM. Bortezomib, ixazomib, and carfilzomib are also widely used for MM. Marizomib, oprozomib, and KZR-616 are in clinical trials. However, the drug resistance of PIs in MM is still a problem. The mechanisms for PIs resistance to MM include ubiquitin-proteasome pathway, autophagy lysosome pathway, endoplasmic reticulum stress pathway, cell survival signal pathway, exosome-mediated resistance, and bone marrow microenvironment-mediated resistance.
多发性骨髓瘤（MM）是一种高度异质性的恶性浆细胞疾病。蛋白酶体抑制剂（PIs）是 MM 的一线药物。硼替佐米、伊沙佐米和卡非佐米也广泛用于 MM。马拉佐米、奥普佐米和 KZR-616 正在临床试验中。然而，PI 在 MM 中的耐药性仍然是一个问题。PI 对 MM 耐药的机制包括泛素-蛋白酶体途径、自噬溶酶体途径、内质网应激途径、细胞存活信号途径、外泌体介导的耐药性和骨髓微环境介导的耐药性。
