文章：

多发性骨髓瘤早期免疫治疗策略的临床证据：后续治疗决策面临的当前挑战

Clinical evidence for immune-based strategies in early-line multiple myeloma: current challenges in decision-making for subsequent therapy

原文发布日期：2023-03-22

DOI: 10.1038/s41408-023-00804-y

类型: Review Article

开放获取: 是

英文摘要：

Almost all patients with multiple myeloma (MM) will eventually develop disease that has relapsed with or become refractory to available treatments and will require additional therapy. However, data are still lacking on how best to sequence regimens in the relapsed/refractory (RR) setting after the failure of early-line lenalidomide, bortezomib, and/or daratumumab, the most commonly used agents in clinical practice today. With the treatment landscape rapidly changing in response to emerging clinical trial data and approvals of several new drugs and additional combinations, it is critically important to focus on patients with RRMM. Variability in patient baseline characteristics, such as the number of prior lines of treatment, refractoriness to prior treatments, prior stem cell transplant, and timing and dosing of prior lenalidomide, makes it difficult to select the best options for patients with RRMM for whom first-line treatments have failed. The aim of this review is to provide both an overview of current therapies and future directions within the RRMM treatment landscape, and a framework for clinicians to choose the most promising next treatment option.
 

摘要翻译： 

几乎所有多发性骨髓瘤（MM）患者最终都会出现疾病复发或对现有治疗产生耐药性，从而需要额外治疗。然而，在临床实践中最常用的来那度胺、硼替佐米和/或达雷妥尤单抗等早期治疗方案失败后，如何最佳地序贯使用复发/难治性（RR）治疗方案，目前仍缺乏相关数据。随着新兴临床试验数据的不断涌现以及多种新药及联合疗法获批，治疗格局正在迅速变化，此时聚焦RRMM患者显得尤为重要。患者基线特征的差异性——如既往治疗线数、对先前治疗的耐药性、既往干细胞移植情况、以及来那度胺的使用时机和剂量——使得为一线治疗失败的RRMM患者选择最佳方案变得困难。本综述旨在概述RRMM治疗领域的当前疗法与未来方向，并为临床医生选择最具前景的后续治疗方案提供参考框架。

原文链接：

Clinical evidence for immune-based strategies in early-line multiple myeloma: current challenges in decision-making for subsequent therapy