CLIN PHARMACOKINET:Venetoclax对复发性或难治性慢性淋巴细胞性白血病的疗效和安全性如何?

2017-06-02 MedSci MedSci原创

近日,国际杂志CLINICAL PHARMACOKINETICS上在线发表一项关于Venetoclax在难治性慢性淋巴细胞白血病病人临床效应和安全性方面的研究。该研究的目的是描述复发性或难治性(R / R)慢性淋巴细胞性白血病(CLL)/小淋巴细胞性淋巴瘤(SLL)患者的Venetoclax暴露与疗效和安全性之间的关系。

Venetoclax是一种选择性,有效的B细胞淋巴瘤-2抑制剂,可恢复癌细胞凋亡,并已证实在各种血液恶性肿瘤中有效。

近日,国际杂志CLINICAL PHARMACOKINETICS上在线发表一项关于Venetoclax难治性慢性淋巴细胞白血病病人临床效应和安全性方面的研究。该研究的目的是描述复发性或难治性(R / R)慢性淋巴细胞性白血病(CLL/小淋巴细胞性淋巴瘤SLL)患者的苯妥英暴露与疗效和安全性之间的关系。

在本项研究中,研究人员合并来自四项临床研究的272名和338名患者,他们分别接受了暴露-疗效和暴露-安全性分析。评估人口统计学,基线疾病特征和选择性协同药物对药物疗效(淋巴细胞,肿瘤大小,客观反应[OR])和安全性(中性粒细胞减少和感染)的影响。

研究显示,高的内皮素浓度可以使淋巴细胞计数和肿瘤大小迅速地减少,这使得病人更快地达到OR。在任何分析中,没有发现17p缺失体细胞突变影响患者对venetoclax的反应性。基于模型的淋巴细胞计数和肿瘤大小的模拟估计,在每天400mg的维生素C剂量下,OR率为84.8%(95%置信区间为81.5-88.0%),较高剂量的ORR增加最小。中性粒细胞减少和感染的不良事件(3级或以上)的安全性分析表明,较高的平均皮质激素浓度与不良事件增加无关。

暴露反应分析表明,每日400毫克的venetoclax剂量方案在R / R CLL / SLL患者中实现OR概率较高(> 80%),嗜中性粒细胞减少或感染风险升高的可能性也较小。

原始出处:

Kevin J. Freise, Aksana K. Jones, Doerthe Eckert. et.al. Impact of Venetoclax Exposure on Clinical Efficacy and Safety in Patients with Relapsed or Refractory Chronic Lymphocytic Leukemia. Clin Pharmacokinet (2017) 56: 505.

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    2017-09-01 canlab
  4. 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createdName=一叶知秋, createdTime=Tue Aug 22 23:44:00 CST 2017, time=2017-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1733872, encodeId=70061e33872ea, content=<a href='/topic/show?id=d4f412668a4' target=_blank style='color:#2F92EE;'>#NET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12668, encryptionId=d4f412668a4, topicName=NET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7ea033781210, createdName=canlab, createdTime=Fri Sep 01 11:44:00 CST 2017, time=2017-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1805121, encodeId=c9ed18051210c, content=<a href='/topic/show?id=3138e790655' target=_blank style='color:#2F92EE;'>#细胞性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77906, encryptionId=3138e790655, topicName=细胞性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=86b7385, createdName=lqrandywkz, createdTime=Thu May 10 22:44:00 CST 2018, time=2018-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1995992, encodeId=0303199599240, content=<a href='/topic/show?id=ed881120ec8' target=_blank style='color:#2F92EE;'>#MAC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11207, encryptionId=ed881120ec8, topicName=MAC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4b65161, createdName=yb6560, createdTime=Tue Aug 01 02:44:00 CST 2017, time=2017-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1909632, encodeId=3163190963267, content=<a href='/topic/show?id=8f1f42518d8' target=_blank style='color:#2F92EE;'>#复发性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42518, encryptionId=8f1f42518d8, topicName=复发性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Tue Nov 21 07:44:00 CST 2017, time=2017-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1720810, encodeId=9af51e208109a, content=<a href='/topic/show?id=634ee040179' target=_blank style='color:#2F92EE;'>#疗效和安全性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70401, encryptionId=634ee040179, topicName=疗效和安全性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=16ef32982072, createdName=经常头晕, createdTime=Thu Aug 24 00:44:00 CST 2017, time=2017-08-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1302063, encodeId=2315130206378, content=<a href='/topic/show?id=82a6659902c' target=_blank style='color:#2F92EE;'>#淋巴细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65990, encryptionId=82a6659902c, topicName=淋巴细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e34303, createdName=wetgdt, createdTime=Sun Jun 04 04:44:00 CST 2017, time=2017-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1391419, encodeId=7800139141935, content=<a href='/topic/show?id=619a535491c' target=_blank style='color:#2F92EE;'>#慢性淋巴细胞性白血病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53549, encryptionId=619a535491c, topicName=慢性淋巴细胞性白血病)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83epHkicC6GE1behbwHywld8qq5n70MWsL3lMUJYYzicic8Fh8tUgSDljeibIQrAeBicATBRXbcCRfFZGK6g/132, createdBy=1d8d2500080, createdName=ms5439512287675881, createdTime=Sun Jun 04 04:44:00 CST 2017, time=2017-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528347, encodeId=3c12152834e7b, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Sun Jun 04 04:44:00 CST 2017, time=2017-06-04, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1787260, encodeId=63411e872601f, content=<a href='/topic/show?id=fa03141591e' target=_blank style='color:#2F92EE;'>#Pharm#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14159, encryptionId=fa03141591e, topicName=Pharm)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Fri Jun 09 01:44:00 CST 2017, time=2017-06-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1908263, encodeId=1ec31908263c5, content=<a href='/topic/show?id=a8d0141605e' target=_blank style='color:#2F92EE;'>#pharma#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14160, encryptionId=a8d0141605e, topicName=pharma)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=一叶知秋, createdTime=Tue Aug 22 23:44:00 CST 2017, time=2017-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1733872, encodeId=70061e33872ea, content=<a href='/topic/show?id=d4f412668a4' target=_blank style='color:#2F92EE;'>#NET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12668, encryptionId=d4f412668a4, topicName=NET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7ea033781210, createdName=canlab, createdTime=Fri Sep 01 11:44:00 CST 2017, time=2017-09-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1805121, encodeId=c9ed18051210c, content=<a href='/topic/show?id=3138e790655' target=_blank style='color:#2F92EE;'>#细胞性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77906, encryptionId=3138e790655, topicName=细胞性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=86b7385, createdName=lqrandywkz, createdTime=Thu May 10 22:44:00 CST 2018, time=2018-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1995992, encodeId=0303199599240, content=<a href='/topic/show?id=ed881120ec8' target=_blank style='color:#2F92EE;'>#MAC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11207, encryptionId=ed881120ec8, topicName=MAC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4b65161, createdName=yb6560, createdTime=Tue Aug 01 02:44:00 CST 2017, time=2017-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1909632, encodeId=3163190963267, content=<a href='/topic/show?id=8f1f42518d8' target=_blank style='color:#2F92EE;'>#复发性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42518, encryptionId=8f1f42518d8, topicName=复发性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Tue Nov 21 07:44:00 CST 2017, time=2017-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1720810, encodeId=9af51e208109a, content=<a href='/topic/show?id=634ee040179' target=_blank style='color:#2F92EE;'>#疗效和安全性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70401, encryptionId=634ee040179, topicName=疗效和安全性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=16ef32982072, createdName=经常头晕, createdTime=Thu Aug 24 00:44:00 CST 2017, time=2017-08-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1302063, encodeId=2315130206378, content=<a href='/topic/show?id=82a6659902c' target=_blank style='color:#2F92EE;'>#淋巴细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65990, encryptionId=82a6659902c, topicName=淋巴细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e34303, createdName=wetgdt, createdTime=Sun Jun 04 04:44:00 CST 2017, time=2017-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1391419, encodeId=7800139141935, content=<a href='/topic/show?id=619a535491c' target=_blank style='color:#2F92EE;'>#慢性淋巴细胞性白血病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53549, encryptionId=619a535491c, topicName=慢性淋巴细胞性白血病)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83epHkicC6GE1behbwHywld8qq5n70MWsL3lMUJYYzicic8Fh8tUgSDljeibIQrAeBicATBRXbcCRfFZGK6g/132, createdBy=1d8d2500080, createdName=ms5439512287675881, createdTime=Sun Jun 04 04:44:00 CST 2017, time=2017-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528347, encodeId=3c12152834e7b, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Sun Jun 04 04:44:00 CST 2017, time=2017-06-04, status=1, ipAttribution=)]
    2017-08-01 yb6560
  6. [GetPortalCommentsPageByObjectIdResponse(id=1787260, encodeId=63411e872601f, content=<a href='/topic/show?id=fa03141591e' target=_blank style='color:#2F92EE;'>#Pharm#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14159, encryptionId=fa03141591e, topicName=Pharm)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Fri Jun 09 01:44:00 CST 2017, time=2017-06-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1908263, encodeId=1ec31908263c5, content=<a href='/topic/show?id=a8d0141605e' target=_blank style='color:#2F92EE;'>#pharma#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14160, encryptionId=a8d0141605e, topicName=pharma)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, 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encryptionId=3138e790655, topicName=细胞性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=86b7385, createdName=lqrandywkz, createdTime=Thu May 10 22:44:00 CST 2018, time=2018-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1995992, encodeId=0303199599240, content=<a href='/topic/show?id=ed881120ec8' target=_blank style='color:#2F92EE;'>#MAC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11207, encryptionId=ed881120ec8, topicName=MAC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4b65161, createdName=yb6560, createdTime=Tue Aug 01 02:44:00 CST 2017, time=2017-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1909632, encodeId=3163190963267, content=<a href='/topic/show?id=8f1f42518d8' target=_blank style='color:#2F92EE;'>#复发性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42518, encryptionId=8f1f42518d8, topicName=复发性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Tue Nov 21 07:44:00 CST 2017, time=2017-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1720810, encodeId=9af51e208109a, content=<a href='/topic/show?id=634ee040179' target=_blank style='color:#2F92EE;'>#疗效和安全性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70401, encryptionId=634ee040179, topicName=疗效和安全性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=16ef32982072, createdName=经常头晕, createdTime=Thu Aug 24 00:44:00 CST 2017, time=2017-08-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1302063, encodeId=2315130206378, content=<a href='/topic/show?id=82a6659902c' target=_blank style='color:#2F92EE;'>#淋巴细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65990, encryptionId=82a6659902c, topicName=淋巴细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e34303, createdName=wetgdt, createdTime=Sun Jun 04 04:44:00 CST 2017, time=2017-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1391419, encodeId=7800139141935, content=<a href='/topic/show?id=619a535491c' target=_blank style='color:#2F92EE;'>#慢性淋巴细胞性白血病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53549, encryptionId=619a535491c, topicName=慢性淋巴细胞性白血病)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83epHkicC6GE1behbwHywld8qq5n70MWsL3lMUJYYzicic8Fh8tUgSDljeibIQrAeBicATBRXbcCRfFZGK6g/132, createdBy=1d8d2500080, createdName=ms5439512287675881, createdTime=Sun Jun 04 04:44:00 CST 2017, time=2017-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528347, encodeId=3c12152834e7b, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Sun Jun 04 04:44:00 CST 2017, time=2017-06-04, status=1, ipAttribution=)]
    2017-11-21 hb2008ye
  7. [GetPortalCommentsPageByObjectIdResponse(id=1787260, encodeId=63411e872601f, content=<a href='/topic/show?id=fa03141591e' target=_blank style='color:#2F92EE;'>#Pharm#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14159, encryptionId=fa03141591e, topicName=Pharm)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Fri Jun 09 01:44:00 CST 2017, time=2017-06-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1908263, encodeId=1ec31908263c5, content=<a href='/topic/show?id=a8d0141605e' target=_blank style='color:#2F92EE;'>#pharma#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14160, encryptionId=a8d0141605e, topicName=pharma)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, 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  9. 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    2017-06-04 freve

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