Mancuso Katia, Barbato Simona, Di Raimondo Francesco, Gay Francesca, Musto Pellegrino, Offidani Massimo, Petrucci Maria Teresa, Zamagni Elena, Zambello Renato, Cavo Michele
IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli", 40138 Bologna, Italy.
Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, 40138 Bologna, Italy.
Cancers (Basel). 2025 Mar 30;17(7):1168. doi: 10.3390/cancers17071168.
The therapeutic landscape for multiple myeloma has gradually expanded in recent decades, leading to unprecedented deep and sustained responses as well as remarkable improvements in patient survival. Nonetheless, changes in treatment algorithms have raised new demands for patients with relapsed/refractory disease, as prior exposure and refractoriness to prior therapies impact the choice of subsequent treatments. In particular, refractoriness to lenalidomide-an established backbone of treatment in both front-line and maintenance settings and a key component of many approved regimens used in relapsed disease-is associated with suboptimal clinical outcomes. Therefore, identifying the most appropriate management in lenalidomide-refractory patients, and even more so in patients who are refractory to more than one agent, is critical. At present, treatment options for this growing subgroup of patients are still limited; however, recent data from clinical research are promising. Herein, we summarized the currently available treatment options and discuss future directions based on the latest results from ongoing clinical trials.
近几十年来，多发性骨髓瘤的治疗领域逐渐扩大，带来了前所未有的深度和持续缓解，以及患者生存率的显著提高。尽管如此，治疗方案的变化对复发/难治性疾病患者提出了新的要求，因为先前的治疗暴露和对先前疗法的难治性会影响后续治疗的选择。特别是，对来那度胺难治——来那度胺是一线和维持治疗中既定的治疗支柱，也是复发疾病中许多获批方案的关键组成部分——与次优的临床结果相关。因此，确定来那度胺难治患者，尤其是对一种以上药物难治的患者的最合适管理至关重要。目前，这一不断增加的患者亚组的治疗选择仍然有限；然而，临床研究的最新数据很有前景。在此，我们总结了目前可用的治疗选择，并根据正在进行的临床试验的最新结果讨论未来方向。
