Hungria Vania, Pinto Neto Jorge Vaz, Garibaldi Pedro Manoel Marques, Jansen Angela Marie, Filho Roberto Jose Pessoa de Magalhães, Pericole Fernando Vieira, Sanku Gayatri, Maiolino Angelo
Clinica São Germano, São Paulo, Brazil.
OncoClínicas Group, Brasília, Federal District, Brazil.
Clin Lymphoma Myeloma Leuk. 2025 Apr;25(4):e200-e209. doi: 10.1016/j.clml.2024.12.001. Epub 2024 Dec 12.
Multiple myeloma treatment has evolved rapidly with the development of novel targeted therapies. The paper outlines multiple myeloma epidemiology, current treatments, and recent advances, highlighting the role of bispecific antibodies. Brazilian authorities have approved 3 bispecific antibodies (teclistamab, elranatamab, and talquetamab) for relapsed/refractory multiple myeloma patients who have received at least three prior therapies. These therapies have shown promising efficacy in clinical trials, with 61%-74% overall response rates. However, access to these treatments varies significantly between Brazil's private and public healthcare systems. A panel of 6 Brazilian experts in multiple myeloma and bispecific antibody therapy convened for a three-day virtual conference organized and moderated by Americas Health Foundation. They addressed key questions regarding bispecific antibody therapy in multiple myeloma and developed consensus recommendations. While bispecific antibodies offer new hope for multiple myeloma patients, challenges remain in ensuring equitable access to these therapies. The paper discusses the sequencing of bispecific antibodies with other treatments, the management of adverse events, and the need for real-world data. It also highlights the disparities in multiple myeloma treatment between Brazil's public and private healthcare systems, emphasizing the need for targeted efforts to bridge this gap and improve outcomes for all multiple myeloma patients.
随着新型靶向疗法的发展，多发性骨髓瘤的治疗方法迅速演变。本文概述了多发性骨髓瘤的流行病学、当前治疗方法以及最新进展，重点介绍了双特异性抗体的作用。巴西当局已批准3种双特异性抗体（替西妥单抗、埃拉纳妥单抗和塔奎妥单抗）用于接受过至少三种先前疗法的复发/难治性多发性骨髓瘤患者。这些疗法在临床试验中显示出了有前景的疗效，总缓解率为61%-74%。然而，在巴西的私立和公共医疗系统中，获得这些治疗的机会存在显著差异。由美洲健康基金会组织和主持的一场为期三天的虚拟会议召集了6位巴西多发性骨髓瘤和双特异性抗体治疗专家组成的小组。他们讨论了多发性骨髓瘤双特异性抗体治疗的关键问题并制定了共识性建议。虽然双特异性抗体为多发性骨髓瘤患者带来了新希望，但在确保公平获得这些疗法方面仍存在挑战。本文讨论了双特异性抗体与其他治疗方法的联合使用顺序、不良事件的管理以及对真实世界数据的需求。它还强调了巴西公共和私立医疗系统在多发性骨髓瘤治疗方面的差异，强调需要有针对性地努力弥合这一差距并改善所有多发性骨髓瘤患者的治疗结果。
