Kraut E H, Ju R, Muller M
Division of Hematology-Oncology and Arthur G. James Cancer Hospital and Research Institute, Ohio State University, Columbus 43210-1240, USA.
Semin Hematol. 1998 Jul;35(3 Suppl 4):32-8.
The standard treatment of multiple myeloma is systemic chemotherapy. Despite 30 years of drug development in myeloma, there are no new drug regimens significantly superior to melphalan and prednisone. In addition, phase II studies of new drugs in myeloma have been disappointing, with low response rates and no prolongation in survival. The topoisomerase I (topo I) inhibitors are a new class of anticancer agents with a wide spectrum of activity in human malignancies. Recent evaluation of the topo I inhibitor topotecan demonstrated activity in advanced myeloma, suggesting a possible role for these drugs in the treatment of this disease. Further evaluation of the mechanisms of resistance to topo I inhibitors, study of combination therapy with topotecan, and evaluation of other topo I poisons in multiple myeloma is proposed.
多发性骨髓瘤的标准治疗方法是全身化疗。尽管在骨髓瘤药物研发方面已有30年，但目前尚无明显优于美法仑和泼尼松的新药物方案。此外，骨髓瘤新药的II期研究结果令人失望，缓解率低且生存期未延长。拓扑异构酶I（topo I）抑制剂是一类新型抗癌药物，在人类恶性肿瘤中具有广泛的活性。最近对topo I抑制剂拓扑替康的评估显示其在晚期骨髓瘤中具有活性，提示这些药物在该疾病治疗中可能发挥作用。建议进一步评估对topo I抑制剂的耐药机制，研究拓扑替康联合治疗方案，并评估其他topo I毒药在多发性骨髓瘤中的作用。
