从疗效判断的变化看多发性骨髓瘤治疗策略的演进

The evolution of multiple myeloma treatment strategies based on changes in effect judgment

  • 摘要: 多发性骨髓瘤(multiple myeloma,MM)在整个血液系统恶性肿瘤研究中进展迅速。其疗效判断标准的持续变化间接证明了这一点。伴随着检测方法的改进和新型药物的上市,MM的完全缓解(completely response,CR)标准正朝着“微观”和“宏观”两个方向发展。相应地也推动了MM治疗策略、治疗理念的不断发展、不断完善。反过来,治疗策略的演进也必将带来缓解深度、广度的进一步提高。这两者的互动推动了整个MM研究的发展。在这一发展的过程中,不断有新的问题产生,这需要更多的临床研究来回答。但不可否认的是MM的整体治疗策略的轮廓越来越清晰。特别需要强调的是,中国医师的相关知识主要来自国外文献,如何结合国情做出具有自己独立思考的选择非常重要。

     

    Abstract: Basic research and clinical research on multiple myeloma (MM) have extensively progressed, as proven by the change in the definition of complete response (CR). With improvements in laboratory technology and introduction of novel agents, CR particularly emphasized both micro- and macro-models. The development of CR yielded therapeutic advances in MM and vice versa. The definitions of response and treatment strategies were closely connected and improved. A need exists for further detailed studies on long-term disease control, such as optimal combination of agents. Given the shortage of new drugs and the distinctiveness of health insurance, Chinese doctors should select the best treatment projects based on real-life situation in China.

     

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