Options for Rescue Treatment of Patients with AL Amyloidosis Exposed to Upfront Daratumumab.

IF 4.7 2区医学 Q1 ONCOLOGY

Current Oncology Reports Pub Date : 2024-09-01 Epub Date: 2024-06-19 DOI:10.1007/s11912-024-01561-2

Claudia Bellofiore, Giovanni Palladini, Paolo Milani

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引用次数: 0

Abstract

Purpose of review: This review aims to assess the therapeutic strategies available for relapsed/refractory patients with immunoglobulin light chain (AL) amyloidosis who received upfront daratumumab-based regimens.

Recent findings: The treatment landscape of AL amyloidosis has changed radically thanks to the introduction in the upfront setting of daratumumab in combination with bortezomib, cyclophosphamide and dexamethasone (DaraCyBorD) which improved patients' outcomes increasing the rate of hematologic and organ responses. However, many patients eventually relapse or are refractory to daratumumab and the best salvage therapy is not well defined yet. In this contest, we reviewed the available therapeutic options after daratumumab failure, and we look towards the current advances in Bcl-2 inhibitors, novel immunotherapeutic agents as chimeric antigen receptor (CAR-T) therapy and bispecific antibodies (bsAbs). Relapsed/refractory AL amyloidosis represent an unmet clinical need and novel targeted drugs require urgent prospective assessment.

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对暴露于前期达拉单抗的 AL 淀粉样变性患者进行挽救性治疗的选择。

综述目的：本综述旨在评估接受达拉单抗前期治疗方案的免疫球蛋白轻链（AL）淀粉样变性病复发/难治患者的治疗策略：由于达拉单抗联合硼替佐米、环磷酰胺和地塞米松（DaraCyBorD）在前期治疗中的引入，AL淀粉样变性病的治疗前景发生了根本性的改变。然而，许多患者最终会复发或对达拉单抗难治，最佳的挽救疗法尚未明确。在本次竞赛中，我们回顾了达拉单抗治疗失败后的可用治疗方案，并展望了 Bcl-2 抑制剂、嵌合抗原受体（CAR-T）疗法和双特异性抗体（bsAbs）等新型免疫治疗药物的最新进展。复发/难治性AL淀粉样变性代表着一种尚未得到满足的临床需求，新型靶向药物急需进行前瞻性评估。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Oncology Reports ONCOLOGY-

CiteScore

8.50

自引率

0.00%

发文量

187

审稿时长

6-12 weeks

期刊介绍： This journal aims to review the most important, recently published clinical findings in the field of oncology. By providing clear, insightful, balanced contributions by international experts, the journal intends to serve all those involved in the care of those affected by cancer. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as cancer prevention, leukemia, melanoma, neuro-oncology, and palliative medicine. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.