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多发性骨髓瘤当前挑战与新兴方法的专家观点:白血病、淋巴瘤和多发性骨髓瘤首次弥合差距会议的叙述性综述

Expert Perspectives on Current Challenges and Emerging Approaches for Multiple Myeloma: Narrative Review of an Inaugural Bridging the Gaps in Leukemia, Lymphoma, and Multiple Myeloma.

作者信息

Chari Ajai, Bal Susan, Ailawadhi Sikander, Krishnan Amrita, Patel Krina K, Berdeja Jesus G, Garfall Alfred, Callander Natalie, Banerjee Rahul, Alsina Melissa, Nooka Ajay K, Dhakal Binod, Gasparetto Cristina, Costello Caitlin

机构信息

Division of Hematology/Oncology, University of California San Francisco, San Francisco, CA.

Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, AL.

出版信息

Clin Lymphoma Myeloma Leuk. 2025 Sep;25(9):635-645. doi: 10.1016/j.clml.2025.03.008. Epub 2025 Mar 11.

Abstract

PURPOSE

The management of multiple myeloma (MM) is becoming increasingly more complex. The approval of novel treatment approaches provides much-needed opportunities but also raises questions and controversies about how to optimally sequence therapies and select treatments for individual patients.

METHODS AND RESULTS

A panel of experts assembled to discuss current controversies in the care of patients with MM across the disease continuum. Workshop topics included: management of smoldering MM; treatment selection for transplant-eligible and transplant-ineligible patients; risk assessment and the possibility of risk-adapted treatment; use of measurable residual disease (MRD) as a clinical trial end point and to guide treatment decisions; management of early relapse; management of triple class-refractory MM; treatment sequencing; and novel therapies.

CONCLUSION

Many controversies remain regarding the management of patients with MM related to risk assessment, treatment selection and sequencing, and the optimal use of current therapies while balancing efficacy, toxicity, patient considerations, and treatment logistics. Ongoing research efforts are needed to further define the optimal use of current therapies and to develop more efficacious therapies for all patients and for particular subset populations with unmet need.

摘要

目的

多发性骨髓瘤(MM)的管理正变得日益复杂。新型治疗方法的获批提供了急需的机会,但也引发了关于如何最佳地安排治疗顺序以及为个体患者选择治疗方案的问题和争议。

方法与结果

召集了一组专家来讨论MM患者在整个疾病过程中护理方面当前存在的争议。研讨会主题包括:冒烟型MM的管理;适合移植和不适合移植患者的治疗选择;风险评估以及风险适应性治疗的可能性;将可测量残留病(MRD)用作临床试验终点并指导治疗决策;早期复发的管理;三重难治性MM的管理;治疗顺序;以及新型疗法。

结论

关于MM患者的管理仍存在许多争议,涉及风险评估、治疗选择和顺序,以及在平衡疗效、毒性、患者因素和治疗安排的同时当前疗法的最佳使用。需要持续的研究努力来进一步明确当前疗法的最佳使用,并为所有患者以及有未满足需求的特定亚组人群开发更有效的疗法。

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