背景:浆细胞恶性肿瘤,多发性骨髓瘤(MM),尽管采用了先进的治疗方案,但仍然无法治愈。Bcl-2(一种抗凋亡蛋白)的过表达,在携带易位的MM中(11;14),有助于抵抗先前的治疗。维奈托克,BCL-2的选择性口服抑制剂是显示作为治疗剂的前景的新型药剂。
目的:本系统评价的目的是探讨维奈托克的使用,单独或作为联合方案,有助于治疗t(11:14)阳性复发/难治性多发性骨髓瘤(RRMM)患者。
方法:本系统评价是根据系统评价和荟萃分析(PRISMA)指南的首选报告项目进行的,并于2022年6月5日完成。在PubMed和Scopus上进行了文献检索,筛选了145篇文章,纳入了10项研究。使用非随机研究方法学指数(MINORS)标准进行偏倚风险评估。
方法:回顾了所有研究,共有311例患者被确定为t(11;14)阳性RRMM。总有效率在33%和95.5%之间。此外,维奈托克的使用表现出良好的不良反应。副作用包括血液学副作用,恶心,呕吐,和腹泻。
结论:维奈托克显示有希望的结果。当服用地塞米松等药物时,达拉图单抗和卡非佐米,在治疗易位(11:14)阳性复发/难治性MM中观察到协同作用。在临床实践中使用维奈托克可以潜在地改善RRMM患者的预后和生活质量。未来的研究应该继续探索这种有希望的治疗方案.
BACKGROUND: The plasma cell malignancy, multiple myeloma (MM), remains incurable despite advanced treatment protocols. Overexpression of Bcl-2 (an anti-apoptotic protein), in MM harboring the translocation (11;14), contributes to resistance to prior therapy. Venetoclax, a selective oral inhibitor of BCL-2 is a novel agent that shows promise as a therapeutic agent.
OBJECTIVE: The objective of this systematic
review is to address how the use of venetoclax, alone or as a combination regimen, contributed to the treatment of patients with t(11:14) positive relapsed/refractory multiple myeloma (RRMM).
METHODS: This systematic
review was conducted in accordance to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was done on 5th June 2022. A literature search was conducted on PubMed and Scopus, 145 articles were screened and 10 studies were included. Risk of bias assessment was performed using the Methodological Index for Non-Randomized Studies (MINORS) criteria.
METHODS: Across the studies reviewed, a total of 311 patients were identified with t(11;14) positive RRMM. The overall response rate achieved ranged between 33% and 95.5%. Furthermore, the use of venetoclax has exhibited a favorable adverse effect profile. Side effects included hematological side effects, nausea, vomiting, and diarrhea.
CONCLUSIONS: Venetoclax demonstrates promising results. When given with drugs like dexamethasone, daratumumab and carfilzomib, a synergistic effect is seen in treating translocation (11:14) positive relapsed/refractory MM. The use of venetoclax in clinical practice can potentially improve outcomes and quality of life in RRMM patients, and future research should continue to explore this promising treatment option.