摘要
高剂量治疗(HDT)后自体干细胞移植(ASCT)仍然是年龄在65岁以下多发性骨髓瘤(MM)患者的护理标准。然而这种治疗方法在过去十年中已经取得了重大进展,主要是由于引入了新药,如沙利度胺,来那度胺和硼替佐米。这些不同组合的新药显示出在诱导治疗和ASCT后显著提高了应答率。此外,ASCT在巩固和维护策略中获得的积极成果强烈支持持续治疗的概念,其最终目标是对疾病的长期控制和治疗结果的改善。调查下一代蛋白酶体抑制剂(如卡菲霉素和ixazomib)的研究的初步数据在前期以及随后的治疗线路中使用,显示了在大多数患者中获得分子缓解的可能性。通过新的药物组合获得的更深层次的反应质疑了ASCT的作用,大量正在进行的第3阶段试验将揭示ASCT的作用和时机。
关键词: 干细胞移植,多发性骨髓瘤,ASCT,蛋白酶体抑制剂,carfilzomib,ixazomib
Current Cancer Drug Targets
Title:Stem Cell Transplantation in Multiple Myeloma
Volume: 17 Issue: 9
关键词: 干细胞移植,多发性骨髓瘤,ASCT,蛋白酶体抑制剂,carfilzomib,ixazomib
摘要: High-dose therapy (HDT) followed by autologous stem cell transplantation (ASCT) remains the standard of care for patients younger than 65 years of age with multiple myeloma (MM). However, this therapeutic approach has undergone substantial advances in this last decade, mainly due to the introduction of new drugs such as thalidomide, lenalidomide and bortezomib. These new drugs, in different combinations, have shown to significantly increase response rates after induction therapy and ASCT. Moreover, the positive results obtained with these agents in consolidation and maintenance strategies after ASCT strongly support the concept of continuous therapy, whose ultimate goal is the long-term control of the disease and the improvement of outcome. Preliminary data from studies investigating next generation proteasome inhibitors, such as carfilzomib and ixazomib, used upfront as well as at subsequent therapeutic lines, demonstrate the possibility of achieving molecular remission in most of the patients. The deeper responses obtained with new drugcombinations questioned the role of ASCT, and large, ongoing, phase 3 trials will shed light on the role and the timing of ASCT.
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Stem Cell Transplantation in Multiple Myeloma, Current Cancer Drug Targets 2017; 17 (9) . https://dx.doi.org/10.2174/1568009616666160920090236
DOI https://dx.doi.org/10.2174/1568009616666160920090236 |
Print ISSN 1568-0096 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-5576 |
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