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Choosing an appropriate salvage therapy for a patient with multiple myeloma

机译:为具有多发性骨髓瘤的患者选择合适的救助疗法

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The introduction of the proteasome inhibitor (PI) bortezomib (V) and immunomodulatory drugs (IMiDs) thalidomide (T) and lenali-domide (R/Revlimide) first in salvage, later in front-line multiple myeloma (MM) regimens has dramatically improved overall survival rates from 3-4 to > 8 years, especially in standard-risk patients. Nevertheless, MM relapses in almost all patients, with the duration of subsequent responses decreasing with each line of therapy due to the emergence of resistant clones. Continuous treatment advances to further improve patient outcome are therefore needed. Excitingly, the armamentarium for salvage therapies has been expanded significantly during the past 5 years, now also including next-generation proteasome inhibitors carfilzomib (K) and ixazomib (I), next-generation IMiD pomalidomide (P), as well as first-in-class monoclonal antibodies elotuzumab (Elo) and dar-atumumab (Dara), and the HDAC inhibitor panobinostat. With several promising additional novel agents in the preclinical and early clinical pipeline, current treatment options in relapsed/refrac-tory MM are anticipated to even further expand in the near future.
机译:蛋白酶体抑制剂(PI)硼喹啉(V)和免疫调节药物(IMID)的引入首先在挽救中首先在挽救中首先在挽救中进行脱麦胺(T)和LENALI-COMIDE(R / RIMIDIDE),后来大致改善了前线多骨髓瘤(MM)方案总生存率从3-4到> 8年,尤其是标准风险患者。然而,MM在几乎所有患者中复发,随后应反应的持续时间随着耐药克隆的出现而降低每种治疗。因此,需要持续治疗进一步改善患者结果的进步。令人兴奋的是,过去5年来拯救疗法的军备疗法已经显着扩展,现在还包括下一代蛋白酶体抑制剂Carfilzomib(K)和Ixazomib(I),下一代酰亚胺吡米德(P),以及首先-Class单克隆抗体Elotuzumab(ELO)和Dar-Atumumab(Dara)和HDAC抑制剂Panobinostat。在临床前和早期临床管道中具有几个有前额外的新型剂,预计复发/稀释摩尔的当前治疗方案将在不久的将来进一步扩展。

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