NEJM: daratumumab、来那度胺联合地塞米松治疗新诊断多发性骨髓瘤

2019-05-31 MedSci MedSci原创

在不符合自体干细胞移植的新诊断多发性骨髓瘤患者中, daratumumab、来那度胺联合地塞米松治疗可显著降低患者疾病进展风险

来那度胺+地塞米松是治疗新诊断的多发性骨髓瘤患者的标准方法,上述患者无法接受自体干细胞移植。近日研究人员考察了daratumumab单抗+来那度胺+地塞米松对无法接受干细胞移植患者疾病进展或死亡风险的影响。

737例新诊断的多发性骨髓瘤患者参与研究,不符合自体干细胞移植要求,分别接受三联治疗 (daratumumab组)或来那度胺+地塞米松治疗(对照组)。研究的主要终点是无进展生存。

在中位随访28.0个月时,240例患者发生疾病进展或死亡,daratumumab组368名患者中的97人(26.4%),对照组369名患者中的143人(38.8%)。daratumumab组30个月时无疾病进展存活率为70.6%,对照组为55.6% (疾病进展或死亡风险比0.56,)。daratumumab组完全缓解率为47.6%,对照组为24.9%(P<0.001)。与对照组7.3%的患者相比,daratummab组24.2%的患者的结果低于最小残留疾病阈值(每105个白细胞1个肿瘤细胞,p<0.001)。3级或4级最常见的不良事件包括中性粒细胞减少(daratumab组50.0%vs对照组35.3%),贫血(11.8% VS 19.7%),淋巴细胞减少(15.1% vs10.7%),肺炎(13.7%vs7.9%)。

在不符合自体干细胞移植的新诊断多发性骨髓瘤患者中, daratumumab、来那度胺联合地塞米松治疗可显著降低患者疾病进展风险。

原始出处:

Thierry Facon et al. Daratumumab plus Lenalidomide and Dexamethasone for Untreated Myeloma. N Engl J Med, May 30, 2019

本文系梅斯医学(MedSci)原创编译整理,转载需授权!

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1915295, encodeId=4bfa191529596, content=<a href='/topic/show?id=e381586e94d' target=_blank style='color:#2F92EE;'>#新诊断#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58679, encryptionId=e381586e94d, topicName=新诊断)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8b48400, createdName=rgjl, createdTime=Tue Oct 01 14:35:00 CST 2019, time=2019-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1890012, encodeId=3b8218900121a, content=<a href='/topic/show?id=760c430895a' target=_blank style='color:#2F92EE;'>#多发性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43089, encryptionId=760c430895a, topicName=多发性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=04d6114, createdName=jml2009, createdTime=Mon Feb 17 15:35:00 CST 2020, time=2020-02-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1912142, encodeId=8ed7191214219, content=<a href='/topic/show?id=4de7112046c' target=_blank style='color:#2F92EE;'>#mAb#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11204, encryptionId=4de7112046c, topicName=mAb)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=25e7304, createdName=snf701207, createdTime=Wed Jan 08 16:35:00 CST 2020, time=2020-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1349672, encodeId=80fb13496e2a1, content=<a href='/topic/show?id=7b2356991f' target=_blank style='color:#2F92EE;'>#Daratumumab#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5699, encryptionId=7b2356991f, topicName=Daratumumab)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=28d456, createdName=yese, createdTime=Sun Jun 02 10:35:00 CST 2019, time=2019-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034836, encodeId=03c810348369f, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Fri May 31 22:35:00 CST 2019, time=2019-05-31, status=1, ipAttribution=)]
    2019-10-01 rgjl
  2. [GetPortalCommentsPageByObjectIdResponse(id=1915295, encodeId=4bfa191529596, content=<a href='/topic/show?id=e381586e94d' target=_blank style='color:#2F92EE;'>#新诊断#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58679, encryptionId=e381586e94d, topicName=新诊断)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8b48400, createdName=rgjl, createdTime=Tue Oct 01 14:35:00 CST 2019, time=2019-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1890012, encodeId=3b8218900121a, content=<a href='/topic/show?id=760c430895a' target=_blank style='color:#2F92EE;'>#多发性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43089, encryptionId=760c430895a, topicName=多发性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=04d6114, createdName=jml2009, createdTime=Mon Feb 17 15:35:00 CST 2020, time=2020-02-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1912142, encodeId=8ed7191214219, content=<a href='/topic/show?id=4de7112046c' target=_blank style='color:#2F92EE;'>#mAb#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11204, encryptionId=4de7112046c, topicName=mAb)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=25e7304, createdName=snf701207, createdTime=Wed Jan 08 16:35:00 CST 2020, time=2020-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1349672, encodeId=80fb13496e2a1, content=<a href='/topic/show?id=7b2356991f' target=_blank style='color:#2F92EE;'>#Daratumumab#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5699, encryptionId=7b2356991f, topicName=Daratumumab)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=28d456, createdName=yese, createdTime=Sun Jun 02 10:35:00 CST 2019, time=2019-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034836, encodeId=03c810348369f, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Fri May 31 22:35:00 CST 2019, time=2019-05-31, status=1, ipAttribution=)]
    2020-02-17 jml2009
  3. [GetPortalCommentsPageByObjectIdResponse(id=1915295, encodeId=4bfa191529596, content=<a href='/topic/show?id=e381586e94d' target=_blank style='color:#2F92EE;'>#新诊断#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58679, encryptionId=e381586e94d, topicName=新诊断)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8b48400, createdName=rgjl, createdTime=Tue Oct 01 14:35:00 CST 2019, time=2019-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1890012, encodeId=3b8218900121a, content=<a href='/topic/show?id=760c430895a' target=_blank style='color:#2F92EE;'>#多发性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43089, encryptionId=760c430895a, topicName=多发性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=04d6114, createdName=jml2009, createdTime=Mon Feb 17 15:35:00 CST 2020, time=2020-02-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1912142, encodeId=8ed7191214219, content=<a href='/topic/show?id=4de7112046c' target=_blank style='color:#2F92EE;'>#mAb#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11204, encryptionId=4de7112046c, topicName=mAb)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=25e7304, createdName=snf701207, createdTime=Wed Jan 08 16:35:00 CST 2020, time=2020-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1349672, encodeId=80fb13496e2a1, content=<a href='/topic/show?id=7b2356991f' target=_blank style='color:#2F92EE;'>#Daratumumab#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5699, encryptionId=7b2356991f, topicName=Daratumumab)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=28d456, createdName=yese, createdTime=Sun Jun 02 10:35:00 CST 2019, time=2019-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034836, encodeId=03c810348369f, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Fri May 31 22:35:00 CST 2019, time=2019-05-31, status=1, ipAttribution=)]
    2020-01-08 snf701207
  4. [GetPortalCommentsPageByObjectIdResponse(id=1915295, encodeId=4bfa191529596, content=<a href='/topic/show?id=e381586e94d' target=_blank style='color:#2F92EE;'>#新诊断#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58679, encryptionId=e381586e94d, topicName=新诊断)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8b48400, createdName=rgjl, createdTime=Tue Oct 01 14:35:00 CST 2019, time=2019-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1890012, encodeId=3b8218900121a, content=<a href='/topic/show?id=760c430895a' target=_blank style='color:#2F92EE;'>#多发性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43089, encryptionId=760c430895a, topicName=多发性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=04d6114, createdName=jml2009, createdTime=Mon Feb 17 15:35:00 CST 2020, time=2020-02-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1912142, encodeId=8ed7191214219, content=<a href='/topic/show?id=4de7112046c' target=_blank style='color:#2F92EE;'>#mAb#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11204, encryptionId=4de7112046c, topicName=mAb)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=25e7304, createdName=snf701207, createdTime=Wed Jan 08 16:35:00 CST 2020, time=2020-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1349672, encodeId=80fb13496e2a1, content=<a href='/topic/show?id=7b2356991f' target=_blank style='color:#2F92EE;'>#Daratumumab#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5699, encryptionId=7b2356991f, topicName=Daratumumab)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=28d456, createdName=yese, createdTime=Sun Jun 02 10:35:00 CST 2019, time=2019-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034836, encodeId=03c810348369f, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Fri May 31 22:35:00 CST 2019, time=2019-05-31, status=1, ipAttribution=)]
    2019-06-02 yese
  5. [GetPortalCommentsPageByObjectIdResponse(id=1915295, encodeId=4bfa191529596, content=<a href='/topic/show?id=e381586e94d' target=_blank style='color:#2F92EE;'>#新诊断#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58679, encryptionId=e381586e94d, topicName=新诊断)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8b48400, createdName=rgjl, createdTime=Tue Oct 01 14:35:00 CST 2019, time=2019-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1890012, encodeId=3b8218900121a, content=<a href='/topic/show?id=760c430895a' target=_blank style='color:#2F92EE;'>#多发性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43089, encryptionId=760c430895a, topicName=多发性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=04d6114, createdName=jml2009, createdTime=Mon Feb 17 15:35:00 CST 2020, time=2020-02-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1912142, encodeId=8ed7191214219, content=<a href='/topic/show?id=4de7112046c' target=_blank style='color:#2F92EE;'>#mAb#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11204, encryptionId=4de7112046c, topicName=mAb)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=25e7304, createdName=snf701207, createdTime=Wed Jan 08 16:35:00 CST 2020, time=2020-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1349672, encodeId=80fb13496e2a1, content=<a href='/topic/show?id=7b2356991f' target=_blank style='color:#2F92EE;'>#Daratumumab#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5699, encryptionId=7b2356991f, topicName=Daratumumab)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=28d456, createdName=yese, createdTime=Sun Jun 02 10:35:00 CST 2019, time=2019-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034836, encodeId=03c810348369f, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Fri May 31 22:35:00 CST 2019, time=2019-05-31, status=1, ipAttribution=)]
    2019-05-31 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

相关资讯

多发性骨髓瘤治疗中的关键问题及临床研究结论

中国高危患者比例较高:我国MM发病率没有很准确的统计学数字,从目前诊治情况看,发病率较之前有所增加,但可能比欧美国家的发病率低。我国MM患者M蛋白类型方面IgD和轻链类型相对多见,另外我国有一些中心报道细胞遗传学高危的患者比例可能高于欧美国家。

Celgene以来那度胺和泊马度胺为基础的三联组合方案,获得欧盟委员会批准用于治疗多发性骨髓瘤

欧盟委员批准了Celgene公司的两种联合治疗多发性骨髓瘤方案:REVLIMID(来那度胺)联合硼替佐米和地塞米松(RVd),用于不符合移植条件,未经过治疗的多发性骨髓瘤成人患者;IMNOVID(泊马度胺)联合硼替佐米和地塞米松(PVd),用于至少接受过一种治疗方案的多发性骨髓瘤成人患者。

Blood:达雷木单抗联合卡非佐米/地塞米松(Dkd)为来那度胺难治性多发性骨髓瘤患者带来新的希望

复发性或难治性多发性骨髓瘤(RRMM)患者的治疗方案有限,存活预后较差。当下,越来越多的选用以来那度胺为基础的疗法作为MM的一线疗法,因此,需要针对来那度胺难治性患者开发新的有效疗法。

多发性骨髓瘤遗传学检测专家共识

多发性骨髓瘤(multiple myeloma,MM)是一种高度异质性的血液系统肿瘤,患者生存时间存在较大差异。根据MM的预后因素进行危险度分层,进行个体化治疗,有助于提高疗效、减轻治疗相关毒性。遗传学异常是MM危险度分层的基础。近年来,虽然遗传学检测对于MM的重要意义在国内已经取得共识,但存在检测方法不规范、阳性阈值混乱、临床价值不明确等一系列问题,亟需规范。为此有必要制订MM的遗传学检测专家共

Blood:休眠骨髓瘤细胞独特的转录特征

在靶向治疗时代,多发性骨髓瘤患者的缓解深度、无进展生存期和总体生存期均获得显著提高。但虽然临床预后有所改善,部分患者会复发,需要进一步治疗。残留在骨骼特殊壁龛内的耐药性休眠骨髓瘤细胞被认为是骨髓瘤复发的基础,仍有很多未知,且难以进行研究。

2018 JSH实践指南:血液恶性肿瘤—骨髓瘤:多发性骨髓瘤相关疾病

2018 JSH实践指南:血液恶性肿瘤—骨髓瘤:多发性骨髓瘤相关疾病,本文主要内容涉及孤立性浆细胞瘤 、轻链淀粉样变性以及POEMS综合征的管理。