多发性骨髓瘤是一种骨髓浆细胞癌，约占血液肿瘤的10%。虽然其通常无法治愈，但过去25年来，出现了一系列非常突出的新疗法，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所利用的多发性骨髓瘤生物学方面。然后对目前和新兴的主要治疗方式进行了回顾，包括以谷氨酰胺调控剂、蛋白酶体抑制剂、单克隆抗体、其他分子靶向疗法（塞利诺尔、维奈托克拉克斯）、嵌合抗原受体T细胞、T细胞结合的双特异性抗体和抗体药物偶联物为代表。讨论了每种疗法的作用机制和临床考虑因素。这些疗法在现代治疗路径中的组合和顺序也在文章结尾进行了讨论，这些治疗路径在近年来显著改善了多发性骨髓瘤患者的预后。《医学年度评论》第75卷的最终在线出版日期预计为2024年1月。请参阅http://www.annualreviews.org/page/journal/pubdates以获取修订后的估计日期。

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. Expected final online publication date for the Annual Review of Medicine, Volume 75 is January 2024. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.