Mettias Sarah, ElSayed Adam, Moore Jonathan, Berenson James R
Berenson Cancer Center, West Hollywood, CA, USA.
Institute for Myeloma and Bone Cancer Research, 9201 W. Sunset Boulevard, Suite 300, West Hollywood, CA, 90069, USA.
Target Oncol. 2025 Mar;20(2):247-267. doi: 10.1007/s11523-024-01122-4. Epub 2025 Jan 29.
Multiple myeloma (MM) is a bone-marrow-based cancer of plasma cells. Over the last 2 decades, marked treatment advances have led to improvements in the overall survival (OS) of patients with this disease. Key developments include the use of chemotherapy, immunomodulatory drugs, proteasome inhibitors, and monoclonal antibodies. MM remains incurable, with outcomes influenced by many factors, including age, sex, genetics, and treatment response. This review summarizes recent studies regarding monitoring and treatment of MM, emphasizing the efficacy of new therapies, the impact of maintenance treatments, and approaches for managing relapsed or refractory MM. The role of specific drug classes used to treat MM, including immunomodulatory drugs, proteasome inhibitors, monoclonal antibodies, and newer treatments such as chimeric antigen receptor T-cell therapies and bispecific antibodies are discussed. Combination therapies have significantly improved outcomes. Maintenance therapies, particularly with lenalidomide, have been effective in extending OS but lead to an increased risk of secondary cancers. Venetoclax, selinexor, and ruxolitinib have shown potential as new therapeutic options for patients with relapsed or refractory MM. Immune-based treatments, such as chimeric antigen receptor T-cell therapy and bispecific antibodies, mark a major advancement for heavily pretreated patients, although challenges remain related to cost, availability, and side effects. The treatment landscape for patients with MM has seen significant progress, with current therapies providing a longer OS and better quality of life. Future research should focus on optimizing these strategies, personalizing therapies, and exploring new therapeutic targets.
多发性骨髓瘤（MM）是一种起源于骨髓浆细胞的癌症。在过去20年中，显著的治疗进展使这种疾病患者的总生存期（OS）得到了改善。关键进展包括化疗、免疫调节药物、蛋白酶体抑制剂和单克隆抗体的使用。MM仍然无法治愈，其预后受许多因素影响，包括年龄、性别、遗传学和治疗反应。本综述总结了关于MM监测和治疗的近期研究，重点强调了新疗法的疗效、维持治疗的影响以及复发或难治性MM的管理方法。讨论了用于治疗MM的特定药物类别，包括免疫调节药物、蛋白酶体抑制剂、单克隆抗体以及嵌合抗原受体T细胞疗法和双特异性抗体等较新的治疗方法。联合疗法显著改善了预后。维持疗法，尤其是来那度胺，在延长OS方面有效，但会增加继发癌症的风险。维奈克拉、塞利尼索和芦可替尼已显示出作为复发或难治性MM患者新治疗选择的潜力。基于免疫的治疗，如嵌合抗原受体T细胞疗法和双特异性抗体，对经过大量预处理的患者来说是一项重大进展，尽管在成本、可及性和副作用方面仍存在挑战。MM患者的治疗格局已取得显著进展，目前的疗法可提供更长的OS和更好的生活质量。未来的研究应专注于优化这些策略、实现个性化治疗以及探索新的治疗靶点。
