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达雷妥尤单抗治疗“真正虚弱”的老年骨髓瘤患者。

Daratumumab Treatment for "Truly Frail" Elderly Myeloma Patients.

作者信息

Horigome Yuichi, Suzuki Kazuhito, Suzuki Takahiro

机构信息

Department of Hematology, Kitasato University Graduate School of Medical Sciences, Sagamihara 252-0373, Kanagawa, Japan.

Division of Clinical Oncology and Hematology, Department of Internal Medicine, The Jikei University School of Medicine, Minato City 105-8461, Tokyo, Japan.

出版信息

Life (Basel). 2024 Mar 15;14(3):389. doi: 10.3390/life14030389.

Abstract

Remarkable advancements have been made in the treatment outcomes of multiple myeloma (MM) patients; however, for frail elderly patients, these treatment outcomes are still insufficient. Elderly MM patients are increasing, as are their treatment regimens. There is a heightened demand to assess these patients in order to provide optimized treatments. While continuous treatment is more common for MM patients when compared to fixed-duration treatment, due to the risk of treatment interruption causing reduced survival rates, effectiveness and safety are essential. Treatment goals vary for each patient, but must preserve their quality of life (QOL). When planning treatments for these patients, frailty evaluation is increasingly emphasized as a stratification factor which helps develop accurate screening tools. Daratumumab (DARA) therapy, used globally, is not only effective in frail elderly MM patients, but also has QOL benefits. Proficiency in utilizing DARA regimens is potentially advantageous for patients not included in clinical trials, and innovative usage can further broaden its scope. The development of tools to accurately assess frailty and the establishment of optimal treatments for frail elderly MM patients are imperative. This review is an overview, challenging the frailty assessments for MM patients, re-examining the evidence for DARA regimens in frail elderly MM patients, and discussing potential areas for improvement.

摘要

多发性骨髓瘤(MM)患者的治疗效果取得了显著进展;然而,对于体弱的老年患者来说,这些治疗效果仍然不够理想。老年MM患者的数量在增加,他们的治疗方案也在增多。为了提供优化治疗,对这些患者进行评估的需求日益增加。与固定疗程治疗相比,MM患者持续治疗更为常见,由于治疗中断有导致生存率降低的风险,有效性和安全性至关重要。每个患者的治疗目标各不相同,但必须保持其生活质量(QOL)。在为这些患者制定治疗计划时,虚弱评估作为一个有助于开发准确筛查工具的分层因素,越来越受到重视。全球使用的达雷妥尤单抗(DARA)疗法不仅对体弱的老年MM患者有效,而且对生活质量也有好处。对于未纳入临床试验的患者,熟练使用DARA方案可能具有优势,创新用法可进一步扩大其应用范围。开发准确评估虚弱的工具并为体弱的老年MM患者建立最佳治疗方法势在必行。本综述是一个概述,对MM患者的虚弱评估提出挑战,重新审视体弱老年MM患者使用DARA方案的证据,并讨论潜在的改进领域。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/25a7/10971975/a16dded7e3ce/life-14-00389-g001.jpg

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