随着血液学领域的快速发展，新的治疗策略和突破性进展不断涌现，为血液恶性肿瘤患者带来了新的希望。在2024年的EHA会议上，《肿瘤瞭望-血液时讯》有幸采访了雅典国立卡波季斯特里安大学医学院的Meletios A.Dimopoulos教授，深入讨论了当前血液恶性肿瘤治疗面临的挑战，特别是对于那些对传统治疗方法如来那度胺和抗CD38单克隆抗体治疗无效的复发/难治性多发性骨髓瘤（RRMM）患者。Dimopoulos教授主导的3期DREAMM-8研究数据展现了B-Pd联合治疗方案的潜力和优势，为二线治疗提供了新的选择。

 

Dimopoulos教授：是的，因为许多患者在来那度胺维持治疗期间出现疾病进展，以及使用抗CD38单抗治疗后也可能出现进展，此时泊马度胺和地塞米松与belantamab mafodotin的联合疗法，显示出作为二线治疗的标准方案的潜力，特别是对于那些在来那度胺和抗CD38单抗治疗失败的患者。

 

Oncology Frontier-Hematology Frontier：Dr.Dimopoulos，belantamab mafodotin with pomalidomide and dexamethasone(B-Pd)regimen demonstrates a significant advantage in enhancing both the quality and duration of responses observed in our simulations，does this mean that B-Pd could become an option after the first-line treatment?

 

Dr.Dimopoulos：Yes，because now many patients progress on lenalidomide maintenance，and we will have more patients progressing on anti-CD38 monoclonal antibodies as well.Thus，a combination that includes pomalidomide and dexamethasone with belantamab mafodotin could become a standard of care for second-line therapy，especially for patients who have failed lenalidomide and anti-CD38 monoclonal antibodies.

 

Dr.Dimopoulos教授：研究结果提示我们，对于在来那度胺和达雷妥尤单抗治疗中出现疾病进展的患者，我们有PVd方案（泊马度胺、硼替佐米联合地塞米松）、卡非佐米联合地塞米松方案以及卡非佐米、泊马度胺联合地塞米松方案可供选择。我们的3期DREAMM-8研究数据表明，belantamab mafodotin与泊马度胺和地塞米松的联合用药在疗效上优于PVd方案，有望成为新的治疗标准。

 

Oncology Frontier-Hematology Frontier：The study showed that the B-Pd regimen significantly improved progression-free survival(PFS)in patients compared to the standard of care.What does this result imply for future treatment strategies?

 

Dr.Dimopoulos：This implies that now we know for patients who have progressed on lenalidomide and daratumumab，we have the PVd regimen，carfilzomib dexamethasone regimen，and the carfilzomib pomalidomide dexamethasone regimen.I believe that the data from this large phase 3 study showing that belantamab mafodotin with pomalidomide and dexamethasone is superior to PVd，we establish B-Pd as a standard of care.

 

Dimopoulos教授：当然，在我们的研究中，大约25%的患者在接受抗CD38单克隆抗体治疗后未能获得持续的疗效。对于这部分患者群体，belanta momafodotin、泊马度胺和地塞米松的联合疗法已被证实能够带来显著的临床疗效改善。因此，我相信，对于在达雷妥尤单抗或艾萨妥昔单抗（Isatuximab，抗CD38单克隆抗体）治疗中出现疾病进展的患者，这种联合疗法是一个有效的治疗选择。这一结论基于对研究数据的深入分析，为临床医生提供了新的治疗方向，以期改善患者的预后和生活质量。

 

Oncology Frontier-Hematology Frontier：what are the implications of the study’s starting results for relapsed/refractory patients who have received prior anti-CD38 therapy，and does the B-Pd regimen offer a new therapeutic option?

 

Dr.Dimopoulos：Certainly.In our study，approximately 25%of patients had failed treatment with anti-CD38 monoclonal antibodies.These patients experienced significant benefits from the combination of belanta momafodotin，pomalidomide，and dexamethasone.This combination therapy provides a new，effective option for patients who have progressed on treatments like daratumumab or isatuximab.The efficacy observed in these patients highlights the potential of this regimen to improve outcomes where other therapies have failed.

 

Dimopoulos教授：这种联合疗法的成功为二线治疗开辟了新的途径。随着我们继续收集更多数据并不断优化治疗方案，我预计将有更多个性化和靶向的治疗方案出现。这不仅会改善患者的预后，还会为那些已用尽标准治疗手段的患者提供更多选择。未来的研究可能会集中在进一步优化这些联合疗法并探索其在更广泛患者群体中的获益。

 

Oncology Frontier-Hematology Frontier：How do you envision the future of second-line therapies evolving with these new findings?

 

Dr.Dimopoulos：The success of this combination therapy opens up new avenues for second-line treatments.As we continue to gather more data and refine our approaches，I anticipate that more personalized and targeted regimens will become available.This will not only improve patient outcomes but also offer more options for those who have exhausted standard treatments.Future research will likely focus on further optimizing these combinations and exploring their benefits in broader patient populations.

 

Dimopoulos教授：EHA会议一直是血液学界的亮点，提供了分享最新研究和临床进展的平台。明年在米兰，我期待看到在靶向治疗和个性化医学发展方面的持续进步。这些进展无疑会为患者带来新的希望和更好的治疗。我们期待着另一个激动人心且富有成果的会议。

 

Oncology Frontier-Hematology Frontier：Looking ahead to next year’s EHA meeting in Milan，what are your expectations for the advancements in hematology?

 

Dr.Dimopoulos：The EHA meetings are always a highlight for the hematology community，offering a platform to share the latest research and clinical advancements.Next year in Milan，I expect to see continued progress in the development of targeted therapies and personalized medicine.These advancements will undoubtedly bring new hope and improved treatments for patients.We’re looking forward to another exciting and productive meeting.