Department of Internal Medicine, McLaren Flint-Michigan State University, Flint, MI, USA.
Levine Cancer Institute, Charlotte, NC, USA.
Crit Rev Oncol Hematol. 2022 Aug;176:103744. doi: 10.1016/j.critrevonc.2022.103744. Epub 2022 Jun 15.
There is increasing evidence regarding the role of various maintenance therapy (MT) strategies after initial induction to treat newly diagnosed transplant-ineligible patients with MM. We reviewed the literature on available regimens for patients with transplant-ineligible newly diagnosed multiple myeloma (NDMM). Lenalidomide (R)-based regimens are still the front-line therapy, but there is an increasing use of bortezomib-based regimens. The MT regimen is mainly based on the initial induction regimen. MT has shown survival benefits compared with patients without maintenance therapy. The most common adverse effects of MT include anemia, neutropenia, thrombocytopenia, infections, and peripheral neuropathy. In conclusion, induction followed by maintenance based on lenalidomide, bortezomib, ixazomib, or daratumumab-based regimens has shown promising results. Therefore, it is essential to conduct more clinical trials to better understand the role of MT in the treatment of NDMM patients who are not candidates for autologous stem cell transplantation.
越来越多的证据表明，在初始诱导治疗后，各种维持治疗（MT）策略在治疗新诊断的不适合移植的多发性骨髓瘤（MM）患者中发挥着作用。我们回顾了适用于不适合移植的新诊断多发性骨髓瘤（NDMM）患者的现有方案的文献。来那度胺（R）为基础的方案仍然是一线治疗，但硼替佐米为基础的方案的使用越来越多。MT 方案主要基于初始诱导方案。与未接受维持治疗的患者相比，MT 显示出了生存获益。MT 最常见的不良反应包括贫血、中性粒细胞减少、血小板减少、感染和周围神经病变。总之，基于来那度胺、硼替佐米、伊沙佐米或达雷妥尤单抗的诱导后维持治疗方案显示出了有前途的结果。因此，开展更多的临床试验来更好地了解 MT 在不适合自体干细胞移植的 NDMM 患者治疗中的作用至关重要。
