Ito Shigeki
Division of Hematology and Oncology, Department of Internal Medicine, Iwate Medical University School of Medicine.
Rinsho Ketsueki. 2023;64(9):1074-1082. doi: 10.11406/rinketsu.64.1074.
The use of novel agents has improved the outcomes of patients with multiple myeloma. However, almost all patients eventually relapsed, became resistant to available treatments, and, thus, required further therapy. To improve the outcomes of relapsed and/or refractory, the best efficacy in each line of treatment should be achieved. Currently, the prognosis of patients who became refractory to triple-class agents including proteasome inhibitors, immunomodulatory drugs, and anti-CD38 antibodies is extremely poor. Moreover, the best treatment regimen for these patients remains unclear. In Japan, the use of B-cell maturation antigen-targeting chimeric antigen receptor T-cell therapy for this patient group was approved. Furthermore, bispecific T-cell engagers and B-cell maturation-targeting antibody-drug conjugate are currently developed. Since it is challenging to identify the optimal sequences, it is important to apply each treatment individually based on clinical trial results. In the educational session, the framework to choose the most optimal treatment based on evidence of relapsed multiple myeloma therapies in each treatment line will be discussed.
新型药物的使用改善了多发性骨髓瘤患者的治疗结果。然而，几乎所有患者最终都会复发，对现有治疗产生耐药性，因此需要进一步治疗。为了改善复发和/或难治性患者的治疗结果，应在每一线治疗中实现最佳疗效。目前，对包括蛋白酶体抑制剂、免疫调节药物和抗CD38抗体在内的三类药物难治的患者预后极差。此外，针对这些患者的最佳治疗方案仍不明确。在日本，针对该患者群体使用靶向B细胞成熟抗原的嵌合抗原受体T细胞疗法已获批准。此外，双特异性T细胞衔接器和靶向B细胞成熟的抗体药物偶联物目前正在研发中。由于确定最佳治疗顺序具有挑战性，因此根据临床试验结果对每种治疗进行个体化应用非常重要。在本次教育课程中，将讨论基于复发多发性骨髓瘤各治疗线治疗证据选择最优化治疗的框架。
