Oncology (Williston Park). 2022 Jul 11;36(7):430-441. doi: 10.46883/2022.25920967.
Treatment paradigms for management of newly diagnosed (ND) multiple myeloma have been evolving over the past 20 years as a consequence of the development of immunomodulatory drugs, proteasome inhibitors, and monoclonal antibodies. While recent studies have continued to confirm the progression-free survival benefit of consolidation with upfront autologous stem cell transplant in those considered transplant eligible (TE), the line between induction strategies for TE and transplant-ineligible (TI) patients has blurred, based on studies evaluating both populations. Here, we present an overview of the data guiding current treatment approaches in the ND setting and discuss areas of ongoing investigation, including the role of quadruplet combination therapies in TE patients, the optimal strategies for frail TI patients, and management of high-risk disease.
在过去的 20 年中，由于免疫调节剂、蛋白酶体抑制剂和单克隆抗体的发展，新诊断（ND）多发性骨髓瘤的治疗模式不断发展。虽然最近的研究继续证实了在符合移植条件（TE）的患者中进行巩固治疗与 upfront 自体干细胞移植的无进展生存期获益，但根据评估这两个人群的研究，TE 和不适合移植（TI）患者的诱导策略之间的界限已经模糊。在这里，我们概述了指导 ND 环境中当前治疗方法的数据，并讨论了正在进行的研究领域，包括四药联合治疗在 TE 患者中的作用、虚弱 TI 患者的最佳策略以及高危疾病的管理。
