Imunoterapija za multipli mijelom

master's thesis

• Title (english): Immunotherapy in multiple myeloma
• Author: Tajana Grenko
• Mentor: Josip Batinić (mentor)
• Committee member: Nadira Duraković (predsjednik povjerenstva)
• Committee member: Jasenka Markeljević (član povjerenstva)
• Committee member: Josip Batinić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2019-07-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Multipli mijelom je B-stanična neoplazma koju karakterizira nekontrolirani rast monoklonskih plazma stanica u koštanoj srži i snažna imunosupresija tumorskog mikrookoliša. Liječenje multiplog mijeloma je uvelike napredovalo tijekom posljednjih nekoliko desetljeća, no unatoč otkriću novih imunomodulatora i inhibitora proteasoma te njihovom značajnom učinku na produljenje preživljenja, bolest je i dalje za većinu pacijenata neizlječiva. Bolje razumijevanje složenih interakcija između imunološkog sustava i multiplog mijeloma dovelo je do ponovnog interesa medicinske znanosti za imunoterapiju. Za razliku od konvencionalne kemoterapije, koja se temelji na kočenju diobenog procesa tumorskih i ostalih brzo dijelećih stanica, imunoterapija je u svom djelovanju mnogo selektivnija te se stoga veže uz manji broj nuspojava. Trenutne imunoterapijske opcije za multipli mijelom su monoklonska protutijela, inhibitori imunoloških kontrolnih točaka, imunomodulatori, alogena transplantacija krvotvornih matičnih stanica, liječenje CAR-T stanicama i tumorska cjepiva. Među novim lijekovima najviše obećavaju monoklonska protutijela daratumumab i elotuzumab, koja su odobrena od strane FDA-e i EMA-e za liječenje novodijagnosticiranog te relapsnog ili refraktornog multiplog mijeloma. Budućnost liječenja multiplog mijeloma kreće se u smjeru individualiziranog pristupa svakom pacijentu te ka kombiniranju antigen-specifične terapije s antigen-nespecifičnom.

Abstract (english)

Multiple myeloma is a B-cell malignancy characterized by unregulated proliferation of monoclonal plasma cells in bone marrow as well as strong immunosuppression in the tumor microenviroment. The treatment of multiple myeloma has evolved dramatically over the past few decades. Despite enormous advances in survival due to the introduction of new
immunomodulatory drugs and proteasome inhibitors, the disease remains incurable for the majority of patients. Improvements in understanding of the complex interactions between the immune system and multiple myeloma have led to restored interest in immunotherapy. While conventional chemotherapy lacks of sensitivity, since it acts upon both tumor cells and rapidly multiplying healthy cells, immunotherapy is much more selective in its action and therefore related to fewer adverse effects. Current immunotherapeutic options for multiple myeloma include monoclonal antibodies, immune checkpoint inhibitors, immunomodulators, allogeneic stem-cell transplantation, CAR-T therapy and tumor vaccines. One of the most promising novel agents are daratumumab and elotuzumab, FDA-approved monoclonal antibodies used in treatment of both newly diagnosed and relapsed disease. The management of multiple myeloma is directing toward personalized therapy for each patient, by combining antigen-specific approaches with antigen-nonspecific.

• Keywords: multipli mijelom; imunoterapija; novi lijekovi; monoklonska protutijela
• Keywords (english): multiple myeloma; immunotherapy; novel agents; monoclonal antibodies
• Language: croatian
• URN:NBN: urn:nbn:hr:105:758435
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2021-03-02 09:46:33