无限的可能性以及如何利用它们? 什么是最佳的治疗顺序?
Rajshekhar Chakraborty1, Divaya Bhutani1, Suzanne Lentzsch1
1Multiple Myeloma and Amyloidosis Program, Division of Hematology/Oncology, Department of Medicine, Columbia University Irving Medical Center, New York, NY.
Hematology. American Society of Hematology. Education Program
|December 5, 2025
概括
新的多发性骨髓瘤治疗方法,如抗CD38抗体四重体和T细胞免疫疗法,正在改变护理. 测序这些疗法,包括CAR-T细胞和双特异性抗体,对于改善患者的治疗结果和管理复发性疾病至关重要.
科学领域:
- 血液学 / 瘤学
- 免疫治疗是一种免疫疗法.
- 药理学 药理学是指药理学的学科.
背景情况:
- 多发性骨髓瘤的治疗已经通过新药显著发展.
- 反CD38单克隆抗体 (mAbs) 和T细胞重定向免疫疗法已经成为关键参与者.
- 这些疗法在疾病连续性的最佳序列化对于最大限度地提高疗效至关重要.
研究的目的:
- 综合来自多发性骨髓瘤治疗药物的关键临床试验的证据.
- 引导治疗决策并优化新疗法的测序.
- 在前线和复发环境中解决不断变化的治疗场景.
主要方法:
- 从多发性骨髓瘤的关键临床试验的数据的审查和综合.
- 对抗CD38 mAbs,CAR T细胞疗法和双特异性抗体 (BsAbs) 的疗效和毒性概况的分析.
- 基于现有证据和新出现的数据对治疗顺序策略的评估.
主要成果:
- 对于符合条件的患者,建议使用前线四重组疗法 (抗CD38 mAb,利那利多米德,博特佐米布/卡菲尔佐米布).
- 针对B细胞成熟抗原 (BCMA) 的化学抗原受体T细胞 (CAR T) 疗法在早期复发中表现出优越性.
- 针对BCMA和GPRC5D的双特异性抗体 (BsAbs) 在晚期复发中表现出活性;在BsAbs之前,CAR T细胞治疗是首选的.
结论:
- 新型药物的战略测序,包括CAR T细胞疗法和BsAbs,对于改善无进展生存 (PFS) 是必不可少的.
- 抗CD38 mAb和基于carfilzomib的三胞胎仍然是非耐药患者的重要选择.
- 需要进行进一步的试验,以建立最佳的测序并确定像PFS-2这样的有价值的终点.
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