Multiple myeloma is a cancer of bone marrow plasma cells that represents approximately 10% of hematologic malignancies. Though it is typically incurable, a remarkable suite of new therapies developed over the last 25 years has enabled durable disease control in most patients. This article briefly introduces the clinical features of multiple myeloma and aspects of multiple myeloma biology that modern therapies exploit. Key current and emerging treatment modalities are then reviewed, including cereblon-modulating agents, proteasome inhibitors, monoclonal antibodies, other molecularly targeted therapies (selinexor, venetoclax), chimeric antigen receptor T cells, T cell–engaging bispecific antibodies, and antibody–drug conjugates. For each modality, mechanism of action and clinical considerations are discussed. These therapies are combined and sequenced in modern treatment pathways, discussed at the conclusion of the article, which have led to substantial improvements in outcomes for multiple myeloma patients in recent years.

中文翻译：

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多发性骨髓瘤的新生物疗法

多发性骨髓瘤是一种骨髓浆细胞癌症，约占血液系统恶性肿瘤的 10%。尽管它通常无法治愈，但过去 25 年开发的一系列卓越的新疗法已经使大多数患者能够持久控制疾病。本文简要介绍了多发性骨髓瘤的临床特征以及现代疗法利用的多发性骨髓瘤生物学的各个方面。然后回顾了当前和新兴的关键治疗方式，包括脑调节剂、蛋白酶体抑制剂、单克隆抗体、其他分子靶向疗法（selinexor、venetoclax）、嵌合抗原受体 T 细胞、T 细胞接合双特异性抗体和抗体药物偶联物。对于每种方式，都讨论了作用机制和临床考虑因素。这些疗法在现代治疗途径中进行组合和排序，在文章的结论部分进行了讨论，近年来多发性骨髓瘤患者的预后得到了实质性改善。