The therapeutic landscape for multiple myeloma has gradually expanded in recent decades, leading to unprecedented deep and sustained responses as well as remarkable improvements in patient survival. Nonetheless, changes in treatment algorithms have raised new demands for patients with relapsed/refractory disease, as prior exposure and refractoriness to prior therapies impact the choice of subsequent treatments. In particular, refractoriness to lenalidomide—an established backbone of treatment in both front-line and maintenance settings and a key component of many approved regimens used in relapsed disease—is associated with suboptimal clinical outcomes. Therefore, identifying the most appropriate management in lenalidomide-refractory patients, and even more so in patients who are refractory to more than one agent, is critical. At present, treatment options for this growing subgroup of patients are still limited; however, recent data from clinical research are promising. Herein, we summarized the currently available treatment options and discuss future directions based on the latest results from ongoing clinical trials.
近年来，多发性骨髓瘤的治疗领域逐步拓展，使得患者能够获得前所未有的深度且持久的缓解，生存期也显著延长。然而，治疗方案的演变对复发/难治性患者提出了新的挑战，因为既往治疗暴露及对先前疗法的耐药性会影响后续治疗的选择。特别是来那度胺作为一线治疗和维持治疗的基础药物，同时也是多种获批用于复发疾病治疗方案的关键组成部分，对其耐药往往与不理想的临床结局相关。因此，为来那度胺耐药患者，尤其是对多种药物耐药的患者，确定最合适的治疗方案至关重要。目前，针对这一日益增长的患者亚群的治疗选择仍然有限；但临床研究的最新数据带来了希望。本文总结了当前可用的治疗方案，并基于正在进行的临床试验的最新结果，探讨了未来的发展方向。
Forcing Ahead: Second-Line Treatment Options for Lenalidomide-Refractory Multiple Myeloma
肿瘤(癌症)患者之家