III．多発性骨髄腫に対する最新治療戦略と展望
多発性骨髄腫に対する治療についてはこれまで免疫調節薬，プロテアソーム阻害薬，抗CD38モノクローナル抗体薬が三本柱であったが，T細胞による免疫療法であるキメラ抗原受容体T細胞療法（CAR-T細胞療法）および二重特異性抗体の高い有効性が報告され，四本目の柱となりつつある．その他にもBCL2阻害剤，新規セレブロン・モジュレーターなど種々の治療法が開発されている．今後，CAR-T細胞療法と二重特異性抗体を軸とした骨髄腫治療のパラダイムシフトが起こるものと予想される．...
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| Published in | 日本内科学会雑誌 Vol. 112; no. 7; pp. 1202 - 1209 |
|---|---|
| Main Authors | , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本内科学会
10.07.2023
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0021-5384 1883-2083 |
| DOI | 10.2169/naika.112.1202 |
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| Abstract | 多発性骨髄腫に対する治療についてはこれまで免疫調節薬，プロテアソーム阻害薬，抗CD38モノクローナル抗体薬が三本柱であったが，T細胞による免疫療法であるキメラ抗原受容体T細胞療法（CAR-T細胞療法）および二重特異性抗体の高い有効性が報告され，四本目の柱となりつつある．その他にもBCL2阻害剤，新規セレブロン・モジュレーターなど種々の治療法が開発されている．今後，CAR-T細胞療法と二重特異性抗体を軸とした骨髄腫治療のパラダイムシフトが起こるものと予想される． |
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| AbstractList | 多発性骨髄腫に対する治療についてはこれまで免疫調節薬，プロテアソーム阻害薬，抗CD38モノクローナル抗体薬が三本柱であったが，T細胞による免疫療法であるキメラ抗原受容体T細胞療法（CAR-T細胞療法）および二重特異性抗体の高い有効性が報告され，四本目の柱となりつつある．その他にもBCL2阻害剤，新規セレブロン・モジュレーターなど種々の治療法が開発されている．今後，CAR-T細胞療法と二重特異性抗体を軸とした骨髄腫治療のパラダイムシフトが起こるものと予想される． |
| Author | 吉原, 哲 吉原, 享子 |
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| References | 6) Cho SF, et al: Bispecific antibodies in multiple myeloma treatment: A journey in progress. Front Oncol 12: 1032775, 2022. 10) Lonial S, et al: Iberdomide plus dexamethasone in heavily pretreated late-line relapsed or refractory multiple myeloma (CC-220-MM-001): a multicentre, multicohort, open-label, phase 1/2 trial. Lancet Haematol 9: e822-e832, 2022. 2) Berdeja JG, et al: 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. Lancet 398: 314-324, 2021. 5) Rodriguez-Otero P, et al: Ide-cel or Standard Regimens in Relapsed and Refractory Multiple Myeloma. N Engl J Med 2023. 9) Diamantidis MD, Papadaki S, Hatjiharissi E: Exploring the current molecular landscape and management of multiple myeloma patients with the t (11; 14) translocation. Front Oncol 12: 934008, 2022. 11) Merrill JT, et al: Phase 2 Trial of Iberdomide in Systemic Lupus Erythematosus. N Engl J Med 386: 1034-1045, 2022. 12) Sellin M, et al: The molecular mechanism and challenge of targeting XPO1 in treatment of relapsed and refractory myeloma. Transl Oncol 22: 101448, 2022. 4) Van Oekelen O, et al: Neurocognitive and hypokinetic movement disorder with features of parkinsonism after BCMA-targeting CAR-T cell therapy. Nat Med 27: 2099-2103, 2021. 13) Lonial S, et al: Management of belantamab mafodotin-associated corneal events in patients with relapsed or refractory multiple myeloma (RRMM). Blood Cancer J 11: 103, 2021. 8) Moreau P, et al: Teclistamab in Relapsed or Refractory Multiple Myeloma. N Engl J Med 387: 495-505, 2022. 1) Munshi NC, et al: Idecabtagene Vicleucel in Relapsed and Refractory Multiple Myeloma. N Engl J Med 384: 705-716, 2021. 3) Martin T, et al: Ciltacabtagene Autoleucel, an Anti-B-cell Maturation Antigen Chimeric Antigen Receptor T-Cell Therapy, for Relapsed/Refractory Multiple Myeloma: CARTITUDE-1 2-Year Follow-Up. J Clin Oncol 2022: Jco2200842. 7) Ma J, et al: Bispecific Antibodies: From Research to Clinical Application. Front Immunol 12: 626616, 2021. |
| References_xml | – reference: 11) Merrill JT, et al: Phase 2 Trial of Iberdomide in Systemic Lupus Erythematosus. N Engl J Med 386: 1034-1045, 2022. – reference: 2) Berdeja JG, et al: 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. Lancet 398: 314-324, 2021. – reference: 8) Moreau P, et al: Teclistamab in Relapsed or Refractory Multiple Myeloma. N Engl J Med 387: 495-505, 2022. – reference: 5) Rodriguez-Otero P, et al: Ide-cel or Standard Regimens in Relapsed and Refractory Multiple Myeloma. N Engl J Med 2023. – reference: 10) Lonial S, et al: Iberdomide plus dexamethasone in heavily pretreated late-line relapsed or refractory multiple myeloma (CC-220-MM-001): a multicentre, multicohort, open-label, phase 1/2 trial. Lancet Haematol 9: e822-e832, 2022. – reference: 7) Ma J, et al: Bispecific Antibodies: From Research to Clinical Application. Front Immunol 12: 626616, 2021. – reference: 3) Martin T, et al: Ciltacabtagene Autoleucel, an Anti-B-cell Maturation Antigen Chimeric Antigen Receptor T-Cell Therapy, for Relapsed/Refractory Multiple Myeloma: CARTITUDE-1 2-Year Follow-Up. J Clin Oncol 2022: Jco2200842. – reference: 12) Sellin M, et al: The molecular mechanism and challenge of targeting XPO1 in treatment of relapsed and refractory myeloma. Transl Oncol 22: 101448, 2022. – reference: 13) Lonial S, et al: Management of belantamab mafodotin-associated corneal events in patients with relapsed or refractory multiple myeloma (RRMM). Blood Cancer J 11: 103, 2021. – reference: 1) Munshi NC, et al: Idecabtagene Vicleucel in Relapsed and Refractory Multiple Myeloma. N Engl J Med 384: 705-716, 2021. – reference: 4) Van Oekelen O, et al: Neurocognitive and hypokinetic movement disorder with features of parkinsonism after BCMA-targeting CAR-T cell therapy. Nat Med 27: 2099-2103, 2021. – reference: 6) Cho SF, et al: Bispecific antibodies in multiple myeloma treatment: A journey in progress. Front Oncol 12: 1032775, 2022. – reference: 9) Diamantidis MD, Papadaki S, Hatjiharissi E: Exploring the current molecular landscape and management of multiple myeloma patients with the t (11; 14) translocation. Front Oncol 12: 934008, 2022. |
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| Title | III．多発性骨髄腫に対する最新治療戦略と展望 |
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