Department of Internal Medicine, Case Western Reserve University, MetroHealth Campus, Cleveland, OH 44109, USA.
Department of Hematology-Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA.
Int J Mol Sci. 2024 Jun 4;25(11):6192. doi: 10.3390/ijms25116192.
Multiple myeloma (MM) is a hematologic malignancy caused by the clonal expansion of immunoglobulin-producing plasma cells in the bone marrow and/or extramedullary sites. Common manifestations of MM include anemia, renal dysfunction, infection, bone pain, hypercalcemia, and fatigue. Despite numerous recent advancements in the MM treatment paradigm, current therapies demonstrate limited long-term effectiveness and eventual disease relapse remains exceedingly common. Myeloma cells often develop drug resistance through clonal evolution and alterations of cellular signaling pathways. Therefore, continued research of new targets in MM is crucial to circumvent cumulative drug resistance, overcome treatment-limiting toxicities, and improve outcomes in this incurable disease. This article provides a comprehensive overview of the landscape of novel treatments and emerging therapies for MM grouped by molecular target. Molecular targets outlined include BCMA, GPRC5D, FcRH5, CD38, SLAMF7, BCL-2, kinesin spindle protein, protein disulfide isomerase 1, peptidylprolyl isomerase A, Sec61 translocon, and cyclin-dependent kinase 6. Immunomodulatory drugs, NK cell therapy, and proteolysis-targeting chimera are described as well.
多发性骨髓瘤(MM)是一种血液系统恶性肿瘤,由骨髓和/或骨髓外部位产生免疫球蛋白的浆细胞克隆性扩张引起。MM 的常见表现包括贫血、肾功能不全、感染、骨痛、高钙血症和疲劳。尽管 MM 治疗模式最近取得了许多进展,但目前的治疗方法显示出有限的长期疗效,疾病复发仍然极为常见。骨髓瘤细胞通过克隆进化和细胞信号通路的改变常常产生药物耐药性。因此,继续研究 MM 的新靶点对于避免累积药物耐药性、克服治疗限制毒性以及改善这种不可治愈疾病的预后至关重要。本文全面概述了按分子靶点分组的 MM 的新型治疗方法和新兴疗法。概述的分子靶点包括 BCMA、GPRC5D、FcRH5、CD38、SLAMF7、BCL-2、驱动蛋白纺锤体蛋白、蛋白质二硫键异构酶 1、肽脯氨酰异构酶 A、Sec61 易位酶和细胞周期蛋白依赖性激酶 6。还描述了免疫调节药物、NK 细胞治疗和蛋白酶体靶向嵌合体。