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CLIN CANCER RES：Venetoclax单药治疗慢性淋巴细胞性白血病安全性分析

2018-09-19 MedSci MedSci原创

慢性淋巴细胞白血病venetoclax安全性
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口服BCL-2抑制剂Venetoclax可以有效治疗复发/难治性慢性淋巴细胞白血病，包括伴有高风险基因突变如17p缺失或B细胞受体抑制剂治疗后进展的高风险疾病。CLIN CANCER RES近期发表了一篇文章，研究Venetoclax单药治疗复发/难治性慢性淋巴细胞白血病的安全性。

口服BCL-2抑制剂Venetoclax可以有效治疗复发/难治性慢性淋巴细胞白血病，包括伴有高风险基因突变如17p缺失或B细胞受体抑制剂治疗后进展的高风险疾病。CLIN CANCER RES近期发表了一篇文章，研究Venetoclax单药治疗复发/难治性慢性淋巴细胞白血病的安全性。

作者使用三个临床试验的数据共350例慢性淋巴细胞白血病患者分析Venetoclax单药 400mg每天的安全性。患者中位年龄66岁，60%存在17p缺失。患者接受过的治疗方案中位数为三，42%的患者接受过Ibrutinib或idelalisib治疗。Venetoclax中位暴露时间为16个月。最常见的不良反应为腹泻，中性粒细胞减少，恶心，贫血，疲劳和上呼吸道感染。最常见的3/4级不良反应为中性粒细胞减少，贫血和血小板减少。3/4级中性粒细胞减少通过剂量调整及生长因子支持后可控，这些患者中有15%出现严重感染。10%的患者由于不良反应中断Venetoclax治疗，8%的患者在研究期间死亡，大部分死亡患者出现疾病进展期间。

文章最后认为，长时间Venetoclax持续治疗在复发/难治性慢性淋巴细胞白血病患者中耐受性良好。

原始出处：
Matthew S.Davids,Michael Hallek,et al.Comprehensive Safety Analysis of Venetoclax Monotherapy for Patients with Relapsed/Refractory Chronic Lymphocytic Leukemia.CLIN CANCER RES.September 2018 doi:10.1158/1078-0432.CCR-17-3761

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    2019-05-17 canlab

    #NET#

    0

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    2019-07-08 lqrandywkz

    #细胞性#

    0

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    2019-02-07 12498717m75(暂无昵称)

    #单药治疗#

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    2018-09-21 wetgdt

    #淋巴细胞#

    0

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    2018-09-21 ms5439512287675881

    #慢性淋巴细胞性白血病#

    0

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现已证实包含抗CD20单克隆抗体obinutuzumab、Bruton酪氨酸激酶抑制剂依鲁替尼和Bcl2抑制剂venetoclax的靶向疗法用于慢性淋巴细胞白血病（CLL）患者具有显著的临床疗效，表明基于互补机制的联合疗法是理想的。但是，将venetoclax与其他活性药物联合使用会增加肿瘤溶解综合征的风险，阻碍了该种联合方案的临床推广。Kerry A. Rogers等研究人员为将这种风险降至最低

JCO：中位缓解持续时间33.2个月！Venetoclax使伴del（17p）难治复发CLL患者获持久缓解

伴17号染色体缺失（del[17p]）或TP53基因突变的慢性淋巴细胞白血病（CLL）患者预后差，Venetoclax可有效提高该类患者缓解率，但早期临床试验结果尚不能明确Venetoclax应答持久性及安全性等问题。近日，JCO杂志发布了Venetoclax治疗伴del（17p）难治复发CLL患者的最新随访结果，旨在评估Venetoclax应答持久性、安全性及患者微小残留灶（MRD）情况。

Blood：信号通路抑制剂在高危的慢性淋巴细胞白血病中的应用

高风险的慢性淋巴细胞白血病（CLL）的定义是对化疗免疫疗法（CIT）具有临床和/或遗传抵抗（TP53异常）。随着通路抑制剂（PI）的可用性，如激酶抑制剂和BCL2拮抗剂，大大提高了CIT耐药性患者的预后。Peter Dreger等人建议修订高危型CLL的定义，即受TP53异常驱动、PI治疗可缓解。I型高危型CLL，CIT耐药的定义为携带TP53异常、临床上的CIT耐药性疾病，但PI治疗可完全缓解。