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多发性骨髓瘤的免疫治疗:目前的状态和将来的方向

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发表于 2015-12-24 22:49:10 | 只看该作者 回帖奖励 |倒序浏览 |阅读模式
Multiple myeloma (MM) is a plasma cell neoplasm which constitutes about 10% of all hematologic malignancies and has been in the limelight of fast-track development of novel drugs that have contributed to the transformation of a rapidly lethal disease into a chronic illness with significant improvement in quality of life. Nonetheless, MM remains an incurable disease in many patients. Immunotherapy has been one of the approaches that had the highest hope for curing this disease. More than two decades of research and clinical trials in immunotherapy for MM have however resulted in very little impact on patient survival. The various immunotherapy approaches that have been attempted over the last two decades but were fraught with failure have already been extensively summarized in many published reviews.Nevertheless, in view of better understanding of the immune checkpoints, the innate immune system, and improved biotechnology, there is renewed hope. In this review, we will briefly discuss the unsuccessful approaches and emphasize the lessons learned, highlight the challenges that lie ahead, and discuss the more promising approaches, that already exist or being developed such as use of allogeneic stem cell transplants (allo-SCT) as a form of cellular immunotherapy, new monoclonal antibodies, chimeric antigen receptor (CAR) T-cell adoptive therapy, and NK cell therapy.
KEYWORDS:
CAR T cells; Immunotherapy; Monoclonal antibodies; Multiple myeloma; NK cells; Stem cell transplant; Vaccines

多发性骨髓瘤的免疫治疗:目前的状态和将来的方向

多发性骨髓瘤(MM)是一种血浆细胞肿瘤,大约占血液系统恶性肿瘤的10% ,急需发展一种新型药物来使得这种快速致命的疾病转化为一种慢性疾病,改善患者的生活质量。尽管如此,MM对于一些病人,仍然是一种无法治愈的疾病。免疫治疗已经成为最有希望治愈这种疾病的方式。虽然超过了20年的研究,但是在临床中这种疾病的生存率仍然很小。在过去的二十年中,不同的免疫治疗方案已经尝试过了,但是都失败了,这些也多次在很多出版的综述中被总结过。尽管如此,鉴于已经能够更好的理解免疫检查点,先天的免疫系统,增强的生物学知识,对于免疫治疗又燃起来了新的希望。在这篇综述中,我们将会简明的 讨论不成功的案例,强调从中得到的启发,重视未来会面临的挑战,讨论更加有前景的治疗方案,例如一些已经存在或者正在发展中的技术,如采用异基因造血干细胞移植(allo-SCT)作为一种新的细胞免疫治疗,新型单克隆抗体,嵌合抗原受体修饰的T细胞过继移植技术,NK细胞治疗技术。

关键词:
CAR-T细胞,免疫治疗,单克隆抗体,多发性骨髓瘤,NK细胞,干细胞移植,疫苗
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