Kegyes David, Bancos Anamaria, Tigu Adrian Bogdan, Rus Ioana, Dima Delia, Cenariu Diana, Nistor Madalina, Munteanu Raluca, Gulei Diana, Tanase Alina, Colita Anca, Buzoianu Anca, Iuga Cristina, Zdrenghea Mihnea, Terpos Evangelos, Ciurea Stefan O, Ciechanover Aaron, Einsele Hermann, Tomuleasa Ciprian
Department of Translational Medicine, Medfuture Institute of Medical Research and Life Sciences, Cluj-Napoca, Romania.
Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Biomark Res. 2025 Aug 15;13(1):105. doi: 10.1186/s40364-025-00825-8.
Multiple myeloma (MM) is a blood cancer characterized by the clonal evolution of plasma cells. In 2022, there were an estimated 118 000 MM cases and 121 000 deaths worldwide. The treatment landscape of MM has undergone a dramatic transformation in recent decades, shifting from conventional chemotherapy to more targeted approaches. In order to overcome intrinsic and acquired resistance mechanisms that frequently restrict the efficacy of single-agent therapies, drug combination strategies have been developed to simultaneously target multiple pathogenetic pathways. Building on the success of immunomodulatory agents, CRBN E3 ligase modulators (CELMoDs), iberdomide (CC-220) and mezigdomide (CC-92480), have been designed as promising and more selective agents. CELMoDs demonstrate a 10-20 times higher binding capacity and they promote a more profound and rapid breakdown of Ikaros and Aiolos compared to traditional immunomodulatory agents. According to the National Cancer Institute Surveillance Program, the median survival for fit patients is greater than ten years, and the 5-year survival for the general MM patient population in the US approaches 60%. Despite these encouraging numbers, MM is still an incurable disease, and the majority of patients eventually relapse and require additional lines of therapy. Combining CELMoDs with cellular therapies significantly improves the response rate in MM patients. In this paper, based on the literature presented at the Annual Meeting of the American Society of Hematology (ASH), the American Society of Clinical Oncology (ASCO), the International Myeloma Society (IMS), and the European Hematology Association (EHA) in the 2020-2025 timeframe, we explore the rationale and emerging evidence of combining CELMoDs with immunotherapies, and their use as a bridge to transplant or as post-ASCT maintenance therapy in MM.
多发性骨髓瘤(MM)是一种以浆细胞克隆性演变为特征的血液癌症。2022年,全球估计有11.8万例MM病例和12.1万例死亡。近几十年来,MM的治疗格局发生了巨大变化,从传统化疗转向了更具针对性的方法。为了克服常常限制单药治疗疗效的内在和获得性耐药机制,已开发出药物联合策略,以同时靶向多种致病途径。基于免疫调节剂的成功,CRBN E3连接酶调节剂(CELMoDs)、iberdomide(CC-220)和mezigdomide(CC-92480)已被设计为有前景且更具选择性的药物。与传统免疫调节剂相比,CELMoDs的结合能力高10至20倍,并且它们能促进Ikaros和Aiolos更深刻、快速的降解。根据美国国立癌症研究所监测项目,身体状况良好的患者的中位生存期超过十年,美国MM患者总体人群的5年生存率接近60%。尽管有这些令人鼓舞的数据,但MM仍然是一种无法治愈的疾病,大多数患者最终会复发并需要额外的治疗方案。将CELMoDs与细胞疗法联合使用可显著提高MM患者的缓解率。在本文中,基于2020 - 2025年期间美国血液学会(ASH)、美国临床肿瘤学会(ASCO)、国际骨髓瘤学会(IMS)和欧洲血液学协会(EHA)年会上发表的文献,我们探讨了将CELMoDs与免疫疗法联合使用的基本原理和新出现的证据,以及它们在MM中作为移植桥梁或ASCT后维持治疗的用途。
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