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Blood:帕纳替尼(Ponatinib)用于慢性髓系白血病和费城染色体阳性白血病患者,可获得持久缓解

2018-03-24 MedSci MedSci原创

中心点:帕纳替尼用于大量预治疗的慢性期的慢性髓系白血病患者时可获得深度、持久的缓解。根据随访5年的结果显示,帕纳替尼用于该患者人群,耐受性可接受。摘要:帕纳替尼(Ponatinib)对原发性和突变型BCR-ABL1,包括BCR-ABL1 T315I,都具有很强的活性。Jorge E. Cortes等人开展一关键的II期PACE试验,对帕纳替尼(起始剂量45mg/日)用于对达沙替尼或尼洛替尼耐药或不

中心点

帕纳替尼用于大量预治疗的慢性期的慢性髓系白血病患者时可获得深度、持久的缓解。

根据随访5年的结果显示,帕纳替尼用于该患者人群,耐受性可接受。

摘要:

帕纳替尼(Ponatinib)对原发性和突变型BCR-ABL1,包括BCR-ABL1 T315I,都具有很强的活性。Jorge E. Cortes等人开展一关键的II期PACE试验,对帕纳替尼(起始剂量45mg/日)用于对达沙替尼或尼洛替尼耐药或不敏感的,或携带BCR-ABL1 T315I突变的慢性髓系白血病(CML)或费城染色体阳性的急性淋巴细胞白血病患者的效果和安全性进行评估。

共招募了449位符合要求的患者。分析集中在处于慢性期的CML(CP-CML)患者(270人),中位随访时间56.8个月,其中267人可参与评估,有60%、40%和24%的患者分别获得主要细胞遗传学缓解(MCyR)、主要分子学缓解(MMR)和MR4.5。在应答的患者中,维持MCyR 5年的概率为82%。2013年10月予以减小剂量,以降低发生动脉闭塞的风险;≥90%的获得MCyR或MMR的CP-CML患者在选择性的减少剂量后维持缓解长达40个月。估计5年总体存活率为73%。

在CP-CML患者中,最常见的需紧急治疗的副反应有皮疹(47%)、腹痛(46%)、血小板减少(46%)、头疼(43%)、干皮症(42%)和便秘(41%)。随时间的推移,CP-CML患者动脉闭塞的累积发病率增加至31%,而经暴露校准的新发动脉闭塞的发病率并未随时间的推移而增加(第1年和第5年分别是15.8和4.9每100人年)。

总而言之,本研究结果表明用帕纳替尼预处理CP-CML患者,可获得持久并具有临床意义的缓解,且不受剂量减少影响。

原始出处:

Jorge E. Cortes,et al.Ponatinib efficacy and safety in Philadelphia chromosome-positive leukemia: final 5-year results of the phase 2 PACE trial.Blood  2018  :blood-2016-09-739086;  doi: https://doi.org/10.1182/blood-2016-09-739086

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    2019-02-21 liye789132251
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  8. 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encodeId=28c0161863492, content=<a href='/topic/show?id=ef3f1449147' target=_blank style='color:#2F92EE;'>#ponatinib#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14491, encryptionId=ef3f1449147, topicName=ponatinib)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=647619916397, createdName=ms1948154235210413, createdTime=Mon Mar 26 04:19:00 CST 2018, time=2018-03-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1628890, encodeId=f8371628890bf, content=<a href='/topic/show?id=da8c92503e7' target=_blank style='color:#2F92EE;'>#费城染色体阳性白血病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92503, encryptionId=da8c92503e7, topicName=费城染色体阳性白血病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=03f421226458, createdName=cy0331, createdTime=Mon Mar 26 04:19:00 CST 2018, time=2018-03-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=299407, encodeId=4de429940e60, content=学习一下谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=142, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Sun Mar 25 04:26:28 CST 2018, time=2018-03-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=299283, encodeId=e8d929928345, content=学习一下谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, 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    2018-03-25 changjiu

    学习一下谢谢

    0

  9. 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    2018-03-24 三生有幸9135

    学习一下谢谢分享

    0

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