在患有多发性骨髓瘤的老年患者中,口服梅尔法兰和普雷尼松化学疗法加上沙利多米德与单独的梅尔法兰和普雷尼松相比:随机对照试验
Antonio Palumbo1, Sara Bringhen, Tommaso Caravita
1Divisione di Ematologia dell'Università di Torino, Azienda Ospedaliera S Giovanni Battista, 10126 Torino, Italy. appalumbo@yahoo.com
Lancet (London, England)
|March 15, 2006
概括
将thalidomide添加到口服梅尔法兰和普雷尼松 (MPT) 中,可显著改善老年多发性骨髓瘤患者的应答率和无事件生存率. 抗凝剂预防对于降低血栓形成风险至关重要.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 临床试验 临床试验
背景情况:
- 自1960年以来,口服梅尔法兰和普雷尼松 (MP) 已成为老年多发性骨髓瘤患者的标准治疗方法.
- 这项研究调查了将thalidomide添加到标准MP疗程的疗效.
研究的目的:
- 为了比较口服梅尔法兰,普雷尼松和沙利多米德 (MPT) 与单独口服梅尔法兰和普雷尼松 (MP) 的疗效和安全性.
- 评估新诊断多发性骨髓瘤的老年患者的应答率和无事件生存率.
主要方法:
- 一个多中心随机试验分配了60-85岁的患者接受口服MPT或单独MP,持续6个4周周期.
- 塔利多米德每天服用100毫克,直到疾病进展或复发.
- 进行了治疗意图分析;该试验以NCT00232934.4号注册.
主要成果:
- 与单独使用MP相比,MPT显示了显著更高的响应率 (76.0%与47.6%) 和改善的2年无事件生存率 (54%与27%).
- 在MPT手臂中,几乎完全或完全的反应率明显高于MPT手臂 (27.9%对比7.2%).
- 在MPT组中,3级或4级不良事件更为频繁 (48%vs. 25%),但以诺沙巴林预防降低了血栓栓塞率,从20%降至3%.
结论:
- 口服MPT是多发性骨髓瘤老年患者的有效一线治疗,改善了关键疗效终点.
- 使用抗凝固剂预防非常重要,以减轻与MPT相关的血栓形成风险增加.
- 需要进一步的随访,以确定MPT对整体存活率的长期影响.
相关概念视频
Treatment Resistant Cancers
Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
Treatment Resistent Cancers
Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel Disease...
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2 (COX-2),...
Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists
5-HT3 receptor antagonists, such as dolasetron, granisetron (Kytril), ondansetron (Zofran), and palonosetron (Axoli), are crucial in managing chemotherapy-induced nausea and vomiting (CINV) and postoperative nausea. These drugs selectively block 5-HT3 receptors in the visceral vagal and spinal afferent nerves, chemoreceptor trigger zone, and the vomiting center. They have a rapid onset of action and can be given as a single dose before chemotherapy. Ondansetron and granisetron, in particular,...
Dosage Regimen: Multiple Oral Dosage
Understanding how a drug's concentration fluctuates within the body over time is crucial in pharmacokinetics, particularly with multiple oral doses. A graphical representation of multiple oral dosages provides insight into these dynamics. Typical accumulation curves of a drug's concentration in the body reveal a sawtooth pattern, indicating periodic peaks and troughs correlating with each dose administration and the drug's subsequent elimination.The plasma concentration at any time during an...

