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Blood:Quizartinib单药治疗复发性/难治性FLT3-ITD突变型急性髓系白血病的效果和安全性

2018-06-07 MedSci MedSci原创

Jorge E. Cortes等人进行一随机的、开放性临床2b期试验,评估quizartinib单药疗法的两种剂量方案治疗既往进行过移植或一次二线补救治疗的复发性/难治性(R/R)FLT3内部串联重复(ITD)突变型急性髓系白血病(AML)患者的疗效和安全性。共招募了76位患者,随机予以quizartinib 30mg/日或60mg/日(逐渐增加至60或90mg/日)口服。等位基因频率≥10%定义

Jorge E. Cortes等人进行一随机的、开放性临床2b期试验,评估quizartinib单药疗法的两种剂量方案治疗既往进行过移植或一次二线补救治疗的复发性/难治性(R/R)FLT3内部串联重复(ITD)突变型急性髓系白血病(AML)患者的疗效和安全性。

共招募了76位患者,随机予以quizartinib 30mg/日或60mg/日(逐渐增加至60或90mg/日)口服。等位基因频率≥10%定义为FLT3-ITD突变型疾病。主要结点是复合完全缓解(CRc)率和QT间期(QTcF)>480msec的发生率。次要结点包括总体存活期(OS)、CRc持续时间、过渡到移植和安全性。

两个治疗臂的CRc率均为47%,与之前采用更高剂量quizartinib的研究报道相近。30mg组和60mg组QTcF>480msec的发生率分别是11%和17%,QTcF>500msec的发生率分别是5%和3%;低于既往大剂量quizartinib的研究报道。60mg组的中位OS、CRc持续时间和过渡到移植率均高于30mg组(20.9 vs 27.3周、4.2 vs 9.1周、32% vs 42%)。30mg组和60mg组分别有61%和14%的患者完成剂量递增。

在评估剂量下,Quizartinib的高临床活性与既往报道一致,并且安全性提高。一半以上的接受30mg quizartinib治疗的患者需增加剂量,提示可对60mg/日的治疗剂量进行进一步深入研究。

原始出处:

Jorge E. Cortes,et al.Phase 2b study of two dosing regimens of quizartinib monotherapy in FLT3-ITD mutated, relapsed or refractory AML.Blood  2018  :blood-2018-01-821629;  doi: https://doi.org/10.1182/blood-2018-01-821629

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    2018-06-22 1530056964

    给了很大的信心给临床医生.

    0

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    2018-06-11 wxl882001

    学习一下

    0

  8. 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7d21503759, createdName=1530056964, createdTime=Fri Jun 22 17:07:28 CST 2018, time=2018-06-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=323325, encodeId=d3c5323325e0, content=学习一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Mon Jun 11 17:04:20 CST 2018, time=2018-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=322861, encodeId=058732286141, content=了解一下.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Sat Jun 09 22:15:18 CST 2018, time=2018-06-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356814, encodeId=512c13568149f, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sat Jun 09 04:55:00 CST 2018, time=2018-06-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1527228, encodeId=fe28152e2287a, content=<a href='/topic/show?id=cadee515ca' target=_blank style='color:#2F92EE;'>#FLT3-ITD#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7515, encryptionId=cadee515ca, topicName=FLT3-ITD)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=db0c11820220, createdName=kord1986, createdTime=Sat Jun 09 04:55:00 CST 2018, time=2018-06-09, status=1, ipAttribution=)]
    2018-06-09 天地飞扬

    了解一下.谢谢分享!

    0

  9. 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Sat Jun 09 22:15:18 CST 2018, time=2018-06-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356814, encodeId=512c13568149f, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sat Jun 09 04:55:00 CST 2018, time=2018-06-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1527228, encodeId=fe28152e2287a, content=<a href='/topic/show?id=cadee515ca' target=_blank style='color:#2F92EE;'>#FLT3-ITD#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7515, encryptionId=cadee515ca, topicName=FLT3-ITD)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=db0c11820220, createdName=kord1986, createdTime=Sat Jun 09 04:55:00 CST 2018, time=2018-06-09, status=1, ipAttribution=)]
    2018-06-09 zhaojie88
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style='color:#2F92EE;'>#FLT3-ITD#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7515, encryptionId=cadee515ca, topicName=FLT3-ITD)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=db0c11820220, createdName=kord1986, createdTime=Sat Jun 09 04:55:00 CST 2018, time=2018-06-09, status=1, ipAttribution=)]
    2018-06-09 kord1986

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表观遗传调控在急性髓系白血病(AML)中常出现突变和异常表达。抑制染色体修饰酶——如组蛋白去甲基化酶赖氨酸特异性去甲基化酶1(LSD1)和组蛋白甲基化转移酶DOT1L——的靶向治疗,开发为用于治疗难治性疾病的新型疗法。这些靶向制剂的共同特点是可诱导髓系分化,提示在髓系基因程序性表达过程中可以应用多种途径来缓解AML中一致看到的分化阻滞。研究人员利用两种独特而有效的分化诱导性靶向表观遗传疗法(LSD

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中心点:FLT3ITD酪氨酸激酶(TK)抑制剂在不影响谷氨酰胺代谢的情况下,抑制糖酵解和葡萄糖利用。FLT3 TK活性的靶点和谷氨酰胺代谢相结合,可降低体内外FLT3ITD突变细胞的白血病致病潜能。摘要:FLT3内部串联重复(FLT3ITD)是急性髓系白血病(AML)的常见突变,与患者预后差相关。尽管新一代的FLT3酪氨酸激酶抑制剂(TKI)显现出客观的结果,但FLT3ITD的AML患者的预后仍不

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