摘要
本文旨在综述多发性骨髓瘤(multiple myeloma,MM)患者来那度胺耐药机制及应对策略的研究进展。全面梳理近3年多发性骨髓瘤、来那度胺耐药机制及应对策略相关研究文献,分析总结来那度胺在MM治疗中的耐药机制及应对策略。来那度胺耐药机制复杂,涵盖肿瘤细胞基因改变、蛋白表达异常、信号通路异常,以及肿瘤微环境中骨髓基质细胞和免疫抑制细胞的影响等。应对策略包括开发如泊马度胺、卡非佐米等新型药物,优化与蛋白酶体抑制剂、单克隆抗体的联合治疗方案,探索嵌合抗原受体T细胞(CAR-T)细胞疗法、双特异性抗体等新治疗技术,以及通过调节骨髓基质细胞、抑制免疫抑制细胞来克服肿瘤微环境耐药。当前,对MM患者来那度胺耐药机制和应对策略已有一定研究成果,但仍需深入探究耐药机制的细节与相互关系,持续开发新型药物,优化联合治疗方案,改进新治疗技术,以进一步提升MM的治疗效果,改善患者预后生活。
This article aims to review the research progress of lenalidomide resistance mechanism and coping strategies in multiple myeloma(MM)patients.The literature related to multiple myeloma,lenalidomide resistance mechanism and coping strategy in recent 3 years was comprehensively reviewed,and the resistance mechanism and coping strategy of lenalidomide in MM treatment were analyzed and summarized.The mechanism of lenalidomide resistance is complex,including gene changes,abnormal protein expression,abnormal signaling pathway,and the influence of bone marrow stromal cells and immunosuppressive cells in the tumor microenvironment.Coping strategies include the development of new drugs such as pomalidomide and carnon-zomib,the optimization of combination therapy with proteasome inhibitors and monoclonal antibodies,the exploration of new therapeutic technologies such as CAR-T cell therapy and bisspecific antibodies,and the modulation of bone marrow stromal cells and the suppression of immunosuppressive cells to overcome tumor microenvironment resistance.At present,there are some research results on the lenalidomide resistance mechanism and coping strategies in MM patients,but it is still necessary to further explore the details and interrelations of the resistance mechanism,continue to develop new drugs,optimize the combination treatment plan,and improve the new treatment technology,so as to further improve the treatment effect of MM and the prognosis of patients.
作者
钱小丽
邓银芬
许月
杨筱
袁红建
Qian Xiaoli;Deng Yinfen;Xu Yue;Yang Xiao;Yuan Hongjian(Taizhou Second People’s Hospital,Taizhou,Jiangsu 225500,China)
出处
《首都食品与医药》
2026年第1期18-24,共7页
Capital Food Medicine
关键词
多发性骨髓瘤
来那度胺
耐药机制
应对策略
multiple myeloma
Lenalidomide
Resistance mechanism
Treatment strategies
