New drugs in the therapy of multiple myeloma

Revista Brasileira de Hematologia e Hemoterapia

Antonio Palumbo¹  Patrizia Falco¹ 

[1] ,Ospedale Molinette Azienda Ospedaliera S. Giovanni Battista Università di TorinoTurin,Italy

关键词: Myeloma;    lenalidomide;    thalidomide;    bortezomib;    therapy;    Mieloma;    lenamidomida;    talidomida;    bortezomibe;    terapia;   

DOI  :  10.1590/S1516-84842008000800005

来源: SciELO

【 摘 要 】

The advances in the understanding of the pathogenesis of multiple myeloma and the mechanism of drug resistance have led to the development of novel targeted therapies that are able to overcome resistance and show additive or synergistic effects with old chemotherapeutic agents. Thalidomide, its immunomodulatory derivative lenalidomide, and the proteasome inhibitor bortezomib, in combination with oral melphalan in the elderly and with intravenous melphalan in younger patients, are changing the traditional treatment paradigm of multiple myeloma. High-dose melphalan followed by autologous stem cell transplantation in the younger patients and oral melphalan-prednisone-thalidomide in the elderly are the standard of care for newly diagnosed multiple myeloma. In younger patients, combinations incorporating thalidomide or lenalidomide or bortezomib significantly increase the pre-transplant response rate before high-dose melphalan and autologous transplantation, and may further improve the response rate and survival achieved after transplant. Prospective randomized studies incorporating new agents and stratifying patients based on cytogenetic abnormalities, are needed to define the therapeutic algorithm in high-risk disease.

【 授权许可】

CC BY-NC-ND   
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