[Multiple myeloma-soon curable?]

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Abstrakt

Tytuł:: [Multiple myeloma-soon curable?]
Autorzy:: Goldschmidt H; Medizinische Klinik V und Nationales Centrum für Tumorerkrankungen (NCT), Universitätsklinikum Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Deutschland. .
Transliterated Title:: Multiples Myelom – bald heilbar?
Źródło:: Der Internist [Internist (Berl)] 2021 May; Vol. 62 (5), pp. 562-570. Date of Electronic Publication: 2021 Mar 30.
Typ publikacji:: Journal Article; Review
Język:: German
Imprint Name(s):: Original Publication: Berlin, New York, Springer-Verlag.
MeSH Terms:: Multiple Myeloma*/diagnosis
Multiple Myeloma*/therapy
Antibodies, Monoclonal ; Germany ; Humans ; Proteasome Inhibitors ; T-Lymphocytes
References:: Durie B (1992), IMF Myeloma Booklet. International Myeloma Foundation.
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Goldschmidt H, Hegenbart U, Wallmeier M et al (1997) High-dose therapy with peripheral blood progenitor cell transplantation in multiple myeloma (MM). Ann Oncol 8:1–4. (PMID: 10.1023/A:1008252227512)
Hillengass J, Merz M, Goldschmidt H (2013) Meeting report of the 4th Heidelberg Myeloma Workshop: current status and developments in diagnosis and therapy of multiple myeloma. J Cancer Res Clin Oncol 139(11):1807–1811. (PMID: 10.1007/s00432-013-1468-3)
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Neben K, Jauch A, Bertsch U et al (2010) Combining information regarding chromosomal aberrations t(4;14) and del(17p13) with the International Staging System classification allows stratification of myeloma patients undergoing autologous stem cell transplantation. Haematologica 95:1150–1157. (PMID: 10.3324/haematol.2009.016436)
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https://gmmg.info/ . Zugegriffen: 12. Febr. 2021.
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Ludwig (2009) Post ASH-Slide.
Contributed Indexing:: Keywords: Diagnostic imaging; Immunotherapy, adoptive; Minimal residual disease; Monoclonal antibodies; Multiple myeloma/treatment monitoring
Local Abstract: [Publisher, German] Das multiple Myelom (MM) ist eine der häufigsten Krebserkrankungen des blutbildenden Systems. In den vergangenen 60 Jahren hat sich die systemische Behandlung mehrfach gewandelt, von Alkylanzien über die Hochdosistherapie gefolgt von autologer Transplantation peripherer Blutstammzellen bis zu immunmodulatorischen Substanzen und Proteasominhibitoren. Heute befindet sich die Therapie des MM erneut im Umbruch. In den letzten Jahren haben monoklonale Antikörper die Therapieoptionen entscheidend erweitert. Langzeitremissionen werden immer häufiger erreicht. Dank immunonkologischer Therapiefortschritte kann in Zukunft die Prognose von intensiv vorbehandelten Patienten mit sehr kurzer Lebenserwartung verbessert werden. Es ist zu erwarten, dass das MM mittelfristig heilbar wird. Die Konzentration der freien Leichtketten im Serum, Läsionen in der Magnetresonanztomographie (MRT) und die Knochenmarkinfiltration sind Parameter, die in die Behandlungsindikation einfließen. In klinischen Studien werden bereits Patienten mit „smoldering myeloma“ behandelt, um die Progression zu verzögern, Remissionsraten zu erhöhen oder Langzeitremissionen mit negativer „minimal residual disease“ zu erreichen. Unter Berücksichtigung chromosomaler Veränderungen und serologischer Parameter wird die Prognose der Patienten mit MM heute sehr gut diskriminiert. In laufenden Studien werden Hochrisikopatienten gesondert und meist aggressiver behandelt. Die Bildgebung hat beim MM einen hohen Stellenwert. Durch eine MRT lassen sich bereits vor einer Knochenzerstörung fokale Läsionen abbilden. In diesem Jahr wird die CAR-T-Zell-Therapie beim MM in Deutschland erstmalig zugelassen. Neue Antikörperkonstrukte sind oder werden eingeführt, so etwa Belantamab Mafodotin für das späte Rezidiv.
Substance Nomenclature:: 0 (Antibodies, Monoclonal)
0 (Proteasome Inhibitors)
Entry Date(s):: Date Created: 20210330 Date Completed: 20210429 Latest Revision: 20210429
Update Code:: 20240105
DOI:: 10.1007/s00108-021-01010-3
PMID:: 33783581
: Czasopismo naukowe

Multiple myeloma (MM) is one of the most frequent cancerous diseases of the hemopoietic system. Over the past 60 years the systemic treatment has undergone multiple changes, from alkylating agents to high-dose therapy followed by autologous peripheral blood stem cell transplantation up to immunomodulating substances and proteasome inhibitors. The treatment of MM is currently undergoing a renewed transition. In recent years monoclonal antibodies have decisively extended the treatment options. Long-term remission is achieved more often. Due to progress in immuno-oncological treatment the prognosis of intensively treated patients with a very short life-expectancy can be improved in the future. It is to be expected that MM will be curable in the medium term. The concentration of free light chains in serum, lesions in magnetic resonance imaging (MRI) and bone marrow infiltration are parameters that are incorporated into the treatment indications. In clinical studies patients with smoldering myeloma are already being treated to delay progression, to increase the remission rates or to achieve long-term remission with negative minimal residual disease. Taking the chromosomal alterations and serological parameters into consideration, the prognosis of patients with MM can nowadays be very well discriminated. In currently running studies high-risk patients are being separately and mostly aggressively treated. Imaging is of great importance in MM. Using MRI focal lesions can be detected even before bone destruction. In this year chimeric antigen receptor (CAR) T cell treatment of MM will be approved for the first time in Germany. Novel antibody constructs, such as belantamab mafodotin, are or will be introduced for a late recurrence.

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