[ASCO2014]Leif P. Bergsagel博士:多发性骨髓瘤治疗进展
编者按:P.Leif Bergsagel,医学博士,美国亚利桑那州梅奥诊所,致力于多发性骨髓瘤的分子发病机制的研究。在第50届ASCO年会上,做了题为“Where We Were, Where We Are, Where We Are Going: Progress in Multiple Myeloma”的精彩演讲。《肿瘤瞭望》就多发性骨髓瘤治疗进展对P.Leif Bergsagel博士进行了采访。
: Bortezomib is a representative of the new drugs playing an increasingly important role in various stages of multiple myeloma therapy. In your opinion, which patients are most likely to benefit from it and which are not?
《肿瘤瞭望》:以硼替佐米为代表的新型药物在多发性骨髓瘤治疗中的各个阶段都发挥着越来越重要的作用,您认为哪些患者能从中获益,哪些不能呢?
Dr Bergsagel: I wouldn’t even call bortezomib a new drug anymore. I would say it is now part of our conventional or standard armamentarium. It is true though that it was only approved around ten or twelve years ago. It is very clear that in newly diagnosed patients with a chromosome translocation between chromosome 4 and 14 that the upfront use of bortezomib abbreviates early mortality in that group. Without question, I think everyone would agree that those patients in particular should receive upfront bortezomib. There is some data, but not quite as robust, about the use of bortezomib maintenance in high-risk patients, particularly those with 17p deletion.
Bergsagel博士:我甚至不愿意称硼替佐米为一种新药。我想说它现在是我们传统或标准的医疗设备的一部分,尽管它在大约十或十二年前才被批准使用。4号染色体和14号染色体之间易位的初治患者,前期使用硼替佐米组患者的早期死亡率降低。毫无疑问,我想大家都会认可预先使用硼替佐米,尤其是对染色体易位的这些患者。有一些研究结果支持高风险患者,应用硼替佐米进行维持治疗,尤其是那些17p缺失的患者。
: There are several clinical trials being presented here at ASCO 2014. Which of them do you consider most clinically valuable?
肿瘤瞭望:在本届ASCO上有许多有关多发骨髓瘤的研究公布,您觉得其中哪些最具有临床价值呢?
Dr Bergsagel: The one that I find the most exciting although not clinically valuable right now, concerns the monoclonal antibodies, CD38. There is daratumumab and one from Sanofi called SAR. Hopefully those drugs progress rapidly and will be approved. The drug that appears may gain imminent approval is panobinostat which is used in combination with bortezomib and dexamethasone and shows a four-month progression-free survival advantage. Hopefully that will get approval and we will be able to start using it.
Bergsagel博士:我觉得最令人兴奋的是单克隆抗体CD38,尽管目前还没有临床价值。目前研发的药物有daratumumab和赛诺菲的SAR。但愿这些药物的研究,进展迅速并被批准使用。可能即将获得批准的药物是帕比司他,它与硼替佐米和地塞米松联合使用,体现了为期四个月的无进展生存期优势。希望帕比司他得到批准,这样我们就能够开始使用了。