Multiple myeloma (MM) represents a hematological neoplasia with an uncontrolled proliferation of malignant plasma cells and complex cytogenetic abnormalities. t(11;14) has emerged as a crucial genetic aberration and is one of the most common primary translocations in MM. Patients harboring t(11;14) represent a distinctive subgroup with a clinical profile that differs from t(11;14)-negative MM risk categories. One of the key features linked with t(11;14) is the BCL2 dependency, indicating vulnerability to BCL2 inhibition. BCL2 inhibitors, such as venetoclax, demonstrated impressive efficacy alone or in combination with other anti-myeloma drugs in patients with RRMM accompanied by t(11;14) and BCL2 overexpression. Therefore, t(11;14) plays a key role in both risk stratification and informed decision making towards a tailored therapy. In this review, we highlight the biology of t(11;14) in MM cells, summarize the current evolving role of t(11;14) in the era of novel agents and novel targeted therapies, illuminate current efficacy and safety data of BCL2-based treatment options and explore the future prospects of individualized precision medicine for this special subgroup of patients with MM.
多发性骨髓瘤（MM）是一种血液系统恶性肿瘤，其特征为恶性浆细胞不受控制地增殖并伴有复杂的细胞遗传学异常。t(11;14)作为关键遗传学异常，是MM中最常见的原发性易位之一。携带t(11;14)的患者构成具有独特临床特征的亚群，其风险分层与t(11;14)阴性MM存在差异。该易位的核心特征之一是与BCL2的依赖性相关，表明其对BCL2抑制剂具有敏感性。在伴有t(11;14)及BCL2过表达的复发难治性MM患者中，以维奈克拉为代表的BCL2抑制剂单药或联合其他抗骨髓瘤药物已展现出显著疗效。因此，t(11;14)在风险分层和制定个体化治疗决策中均具有关键作用。本综述重点阐述t(11;14)在MM细胞中的生物学特性，总结新型药物及靶向治疗时代t(11;14)不断演变的临床意义，系统阐述基于BCL2抑制治疗方案的最新疗效与安全性数据，并展望该特殊MM亚群个体化精准治疗的未来发展方向。
The Role of t(11;14) in Tailoring Treatment Decisions in Multiple Myeloma
肿瘤(癌症)患者之家