埃罗妥珠单抗联合免疫调节药治疗多发性骨髓瘤的研究进展

Research progress on combination therapy of elotuzumab and immunomodulators in multiple myeloma

多发性骨髓瘤(MM)是常见的血液肿瘤, 患者预后较差, 目前其主要治疗方法为多药联合治疗。其中, 单克隆抗体与免疫调节药(IMiD)联合治疗MM是相关研究热点, 并取得可观临床效果。埃罗妥珠单抗(elotuzumab)是一种人源化免疫球蛋白(Ig)Gκ单克隆抗体, 靶向作用于MM细胞中高表达的信号淋巴细胞激活分子(SLAMF)7, 是MM的首个免疫刺激疗法药物。埃罗妥珠单抗与IMiD(来那度胺、沙利度胺、泊马度胺)联合治疗复发/难治性MM(RRMM), 对延长患者生存期具有重要意义。近年来, 埃罗妥珠单抗联合IMiD治疗新诊断MM的临床试验亦正在开展中, 但疗效尚存争议。笔者拟对埃罗妥珠单抗的作用机制, 埃罗妥珠单抗联合IMiD治疗RRMM和新诊断MM患者的疗效及不良反应的研究进展进行综述, 旨在对单克隆抗体联合IMiD应用于MM患者的治疗提供理论依据。

Multiple myeloma(MM)is a common hematologic malignancy with poor prognosis,and the main treatment approach currently is multi-drug combination therapy.Among them,the combination therapy of monoclonal antibodies and immunomodulators(IMiD)is a research hotspot and has shown significant clinical efficacy.Elotuzumab,the first immunostimulatory therapy drug for MM,is a humanized immunoglubin(Ig)Gκ monoclonal antibody that targets the highly expressed signaling lymphocyte-activating molecule(SLAMF)7 in MM cells.The combination therapy of elotuzumab and IMiD(lenalidomide,thalidomide,pomalidomide)in the treatment of recurrent/refractory MM(RRMM)has great significance in prolonging survival of patients.In recent years,clinical trials of elotuzumab and IMiD combination treatment for newly diagnosed MM are ongoing,but its efficacy is controversial.This article intends to elaborate the research progress of mechanism of elotuzumab,the efficacy and adverse reactions of elotuzumab combined with IMiD in the treatment of RRMM and newly diagnosed MM,in order to provide theoretical basis for the application of monoclonal antibodies combined with IMiD in the treatment of MM.