Multiple myeloma (MM) treatment remains challenging due to its relapsed/refractory disease course as well as intra- and inter-patient heterogeneity. Cellular immunotherapies, especially chimeric antigen receptor (CAR)-T cells targeting B cell maturation antigen (BCMA), mark a major breakthrough, achieving long-lasting remissions and instilling hope for a potential cure. While ongoing clinical trials are increasingly driving approved cellular products towards earlier lines of therapy, novel targets as well as advanced approaches employing natural killer (NK) cells or dendritic cell (DC) vaccines are currently under investigation. Treatment resistance, driven by tumor-intrinsic factors such as antigen escape and the intricate dynamics of the tumor microenvironment (TME), along with emerging side effects such as movement and neurocognitive treatment-emergent adverse events (MNTs), are the major limitations of approved cellular therapies. To improve efficacy and overcome resistance, cutting-edge research is exploring strategies to target the microenvironment as well as synergistic combinatorial approaches. Recent advances in CAR-T cell production involve shortened manufacturing protocols and “off-the-shelf” CAR-T cells, aiming at decreasing socioeconomic barriers and thereby increasing patient access to this potential lifesaving therapy. In this review, we provide an extensive overview of the evolving field of cellular therapies for MM, underlining the potential to achieve long-lasting responses.
多发性骨髓瘤（MM）的治疗因其复发/难治性病程以及患者内部和患者间的异质性而持续面临挑战。细胞免疫疗法，特别是靶向B细胞成熟抗原（BCMA）的嵌合抗原受体（CAR）-T细胞，标志着重大突破，实现了长期缓解，并为潜在治愈带来了希望。尽管正在进行的临床试验正逐步推动已获批的细胞产品向更早期治疗线发展，但针对新靶点以及采用自然杀伤（NK）细胞或树突状细胞（DC）疫苗的先进方法目前正处于研究阶段。由抗原逃逸等肿瘤内在因素及肿瘤微环境（TME）复杂动态驱动的治疗耐药性，以及运动和神经认知治疗相关不良事件（MNTs）等新出现的副作用，是已获批细胞疗法的主要局限。为提高疗效并克服耐药，前沿研究正在探索靶向微环境的策略以及协同组合疗法。CAR-T细胞生产的最新进展包括缩短制备流程和开发“现货型”CAR-T细胞，旨在降低社会经济障碍，从而让更多患者有机会获得这种潜在的挽救生命的疗法。本综述全面概述了多发性骨髓瘤细胞治疗领域的发展动态，强调了实现长期缓解的潜力。
肿瘤(癌症)患者之家