多发性骨髓瘤的治疗进展
Advances in the Treatment of Multiple Myeloma
DOI: 10.12677/acm.2026.1641697, PDF,   
作者: 余佳琦:赣南医科大学第一临床医学院,江西 赣州;陈懿建*:赣南医科大学第一附属医院血液内科,江西 赣州
关键词: 多发性骨髓瘤治疗靶向治疗免疫治疗Multiple Myeloma Treatment Targeted Therapy Immunotherapy
摘要: 多发性骨髓瘤(multiple myeloma, MM)是一种以浆细胞恶性增殖为特征的血液系统恶性肿瘤,它约占所有血液系统恶性肿瘤的10%。由于MM具有高度异质性和多样的生物学特征,生存期差别大,目前仍被认为难以治愈。近年来,随着新药的出现及新疗法的发展,MM的治疗模式发生了巨大变革。本文主要对临床上部分MM的治疗药物进行综述。
Abstract: Multiple myeloma (MM) is a hematological malignancy characterized by the malignant proliferation of plasma cells, accounting for approximately 10% of all hematological malignancies. Due to its high heterogeneity and diverse biological characteristics, MM presents with wide variability in patient survival and is still considered an incurable disease to date. In recent years, with the advent of novel agents and the development of new therapeutic strategies, the treatment paradigm of MM has undergone tremendous transformation. This article mainly reviews several clinically used therapeutic agents for MM.
文章引用:余佳琦, 陈懿建. 多发性骨髓瘤的治疗进展[J]. 临床医学进展, 2026, 16(4): 4295-4300. https://doi.org/10.12677/acm.2026.1641697

参考文献

[1] Dimopoulos, M.A., Kastritis, E. and Ghobrial, I.M. (2016) Waldenström’s Macroglobulinemia: A Clinical Perspective in the Era of Novel Therapeutics. Annals of Oncology, 27, 233-240. [Google Scholar] [CrossRef] [PubMed]
[2] Liu, J., Liu, W., Mi, L., Zeng, X., Cai, C., Ma, J., et al. (2019) Incidence and Mortality of Multiple Myeloma in China, 2006-2016: An Analysis of the Global Burden of Disease Study 2016. Journal of Hematology & Oncology, 12, Article No. 136. [Google Scholar] [CrossRef] [PubMed]
[3] Patir, P., Cerci, K. and Kurtoglu, E. (2025) Prognostic Evaluation of Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) Score and Hematological Indices in Classic Hodgkin Lymphoma. International Journal of Laboratory Hematology, 47, 68-78. [Google Scholar] [CrossRef] [PubMed]
[4] Kyle, R.A., Gertz, M.A., Witzig, T.E., Lust, J.A., Lacy, M.Q., Dispenzieri, A., et al. (2003) Review of 1027 Patients with Newly Diagnosed Multiple Myeloma. Mayo Clinic Proceedings, 78, 21-33. [Google Scholar] [CrossRef] [PubMed]
[5] Durie, B.G.M., Hoering, A., Abidi, M.H., Rajkumar, S.V., Epstein, J., Kahanic, S.P., et al. (2017) Bortezomib with Lenalidomide and Dexamethasone versus Lenalidomide and Dexamethasone Alone in Patients with Newly Diagnosed Myeloma without Intent for Immediate Autologous Stem-Cell Transplant (SWOG S0777): A Randomised, Open-Label, Phase 3 Trial. The Lancet, 389, 519-527. [Google Scholar] [CrossRef] [PubMed]
[6] Dimopoulos, M.A., Moreau, P., Palumbo, A., Joshua, D., Pour, L., Hájek, R., et al. (2016) Carfilzomib and Dexamethasone versus Bortezomib and Dexamethasone for Patients with Relapsed or Refractory Multiple Myeloma (ENDEAVOR): A Randomised, Phase 3, Open-Label, Multicentre Study. The Lancet Oncology, 17, 27-38. [Google Scholar] [CrossRef] [PubMed]
[7] Richardson, P.G., Kumar, S.K., Masszi, T., Grzasko, N., Bahlis, N.J., Hansson, M., et al. (2021) Final Overall Survival Analysis of the TOURMALINE-MM1 Phase III Trial of Ixazomib, Lenalidomide, and Dexamethasone in Patients with Relapsed or Refractory Multiple Myeloma. Journal of Clinical Oncology, 39, 2430-2442. [Google Scholar] [CrossRef] [PubMed]
[8] Dimopoulos, M.A., Chen, C., Spencer, A., Niesvizky, R., Attal, M., Stadtmauer, E.A., et al. (2009) Long-Term Follow-Up on Overall Survival from the MM-009 and MM-010 Phase III Trials of Lenalidomide Plus Dexamethasone in Patients with Relapsed or Refractory Multiple Myeloma. Leukemia, 23, 2147-2152. [Google Scholar] [CrossRef] [PubMed]
[9] Richardson, P.G., Siegel, D.S., Vij, R., et al. (2014) Pomalidomide Alone or in Combination with Low-Dose Dexamethasone in Relapsed and Refractory Multiple Myeloma: A Randomized Phase 2 Study. Blood, 123, 3208-3209. [Google Scholar] [CrossRef
[10] Chari, A., Vogl, D.T., Gavriatopoulou, M., Nooka, A.K., Yee, A.J., Huff, C.A., et al. (2019) Oral Selinexor-Dexamethasone for Triple-Class Refractory Multiple Myeloma. New England Journal of Medicine, 381, 727-738. [Google Scholar] [CrossRef] [PubMed]
[11] Kumar, S.K., Harrison, S.J., Cavo, M., de la Rubia, J., Popat, R., Gasparetto, C., et al. (2020) Venetoclax or Placebo in Combination with Bortezomib and Dexamethasone in Patients with Relapsed or Refractory Multiple Myeloma (BELLINI): A Randomised, Double-Blind, Multicentre, Phase 3 Trial. The Lancet Oncology, 21, 1630-1642. [Google Scholar] [CrossRef] [PubMed]
[12] Wudhikarn, K., Wills, B. and Lesokhin, A.M. (2020) Monoclonal Antibodies in Multiple Myeloma: Current and Emerging Targets and Mechanisms of Action. Best Practice & Research Clinical Haematology, 33, Article 101143. [Google Scholar] [CrossRef] [PubMed]
[13] Timmers, M., Roex, G., Wang, Y., Campillo-Davo, D., Van Tendeloo, V.F.I., Chu, Y., et al. (2019) Chimeric Antigen Receptor-Modified T Cell Therapy in Multiple Myeloma: Beyond B Cell Maturation Antigen. Frontiers in Immunology, 10, Article ID: 1613. [Google Scholar] [CrossRef] [PubMed]
[14] van de Donk, N.W.C.J., Richardson, P.G. and Malavasi, F. (2018) CD38 Antibodies in Multiple Myeloma: Back to the Future. Blood, 131, 13-29. [Google Scholar] [CrossRef] [PubMed]
[15] Dimopoulos, M.A., Oriol, A., Nahi, H., San-Miguel, J., Bahlis, N.J., Usmani, S.Z., et al. (2016) Daratumumab, Lenalidomide, and Dexamethasone for Multiple Myeloma. New England Journal of Medicine, 375, 1319-1331. [Google Scholar] [CrossRef] [PubMed]
[16] Spencer, A., Lentzsch, S., Weisel, K., Avet-Loiseau, H., Mark, T.M., Spicka, I., et al. (2018) Daratumumab Plus Bortezomib and Dexamethasone versus Bortezomib and Dexamethasone in Relapsed or Refractory Multiple Myeloma: Updated Analysis of Castor. Haematologica, 103, 2079-2087. [Google Scholar] [CrossRef] [PubMed]
[17] Chari, A., Suvannasankha, A., Fay, J.W., Arnulf, B., Kaufman, J.L., Ifthikharuddin, J.J., et al. (2017) Daratumumab Plus Pomalidomide and Dexamethasone in Relapsed and/or Refractory Multiple Myeloma. Blood, 130, 974-981. [Google Scholar] [CrossRef] [PubMed]
[18] An, G., Jiang, H., Acharya, C., Zhong, M.Y., Cai, T., Yang, G., et al. (2014) SAR 650984, a Therapeutic Anti-Cd38 Monoclonal Antibody, Blocks CD38-CD31 Interaction in Multiple Myeloma. Blood, 124, 4729-4729. [Google Scholar] [CrossRef
[19] Attal, M., Richardson, P.G., Rajkumar, S.V., San-Miguel, J., Beksac, M., Spicka, I., et al. (2019) Isatuximab Plus Pomalidomide and Low-Dose Dexamethasone versus Pomalidomide and Low-Dose Dexamethasone in Patients with Relapsed and Refractory Multiple Myeloma (ICARIA-MM): A Randomised, Multicentre, Open-Label, Phase 3 Study. The Lancet, 394, 2096-2107. [Google Scholar] [CrossRef] [PubMed]
[20] Dimopoulos, M.A., Dytfeld, D., Grosicki, S., Moreau, P., Takezako, N., Hori, M., et al. (2018) Elotuzumab Plus Pomalidomide and Dexamethasone for Multiple Myeloma. New England Journal of Medicine, 379, 1811-1822. [Google Scholar] [CrossRef] [PubMed]
[21] Berdeja, J.G., Madduri, D., Usmani, S.Z., Jakubowiak, A., Agha, M., Cohen, A.D., et al. (2021) Ciltacabtagene Autoleucel, a B-Cell Maturation Antigen-Directed Chimeric Antigen Receptor T-Cell Therapy in Patients with Relapsed or Refractory Multiple Myeloma (CARTITUDE-1): A Phase 1b/2 Open-Label Study. The Lancet, 398, 314-324. [Google Scholar] [CrossRef] [PubMed]
[22] Hu, Y., Hou, J., Jiang, Z. and Lin, Q. (2025) Mechanisms of Resistance to CAR-T Cell Therapy in Multiple Myeloma: Latest Updates from the 2024 ASH Annual Meeting. Experimental Hematology & Oncology, 14, Article No. 45. [Google Scholar] [CrossRef] [PubMed]
[23] Neri, P., Leblay, N., Lee, H., Gulla, A., Bahlis, N.J. and Anderson, K.C. (2024) Just Scratching the Surface: Novel Treatment Approaches for Multiple Myeloma Targeting Cell Membrane Proteins. Nature Reviews Clinical Oncology, 21, 590-609. [Google Scholar] [CrossRef] [PubMed]
[24] Usmani, S.Z., Garfall, A.L., van de Donk, N.W.C.J., Nahi, H., San-Miguel, J.F., Oriol, A., et al. (2021) Teclistamab, a B-Cell Maturation Antigen × CD3 Bispecific Antibody, in Patients with Relapsed or Refractory Multiple Myeloma (Majestec-1): A Multicentre, Open-Label, Single-Arm, Phase 1 Study. The Lancet, 398, 665-674. [Google Scholar] [CrossRef] [PubMed]
[25] Chari, A., Touzeau, C., Schinke, C., Minnema, M.C., Berdeja, J.G., Oriol, A., et al. (2025) Safety and Activity of Talquetamab in Patients with Relapsed or Refractory Multiple Myeloma (Monumental-1): A Multicentre, Open-Label, Phase 1-2 Study. The Lancet Haematology, 12, e269-e281. [Google Scholar] [CrossRef] [PubMed]
[26] Hungria, V., Robak, P., Hus, M., Zherebtsova, V., Ward, C., Ho, P.J., et al. (2024) Belantamab Mafodotin, Bortezomib, and Dexamethasone for Multiple Myeloma. New England Journal of Medicine, 391, 393-407. [Google Scholar] [CrossRef] [PubMed]
[27] Dimopoulos, M.A., Beksac, M., Pour, L., Delimpasi, S., Vorobyev, V., Quach, H., et al. (2024) Belantamab Mafodotin, Pomalidomide, and Dexamethasone in Multiple Myeloma. New England Journal of Medicine, 391, 408-421. [Google Scholar] [CrossRef] [PubMed]