在慢性淋巴细胞白血病患者中,B细胞受体路径突变很少发生,这些患者在持续的易布鲁替尼治疗中
Jennifer A Woyach1, Paolo Ghia2, John C Byrd3
1The Ohio State University Comprehensive Cancer Center, Columbus, Ohio.
概括
在没有疾病进展的慢性淋巴细胞白血病 (CLL) 患者中,布鲁顿的氨酸激酶 (BTK) 和脂酶C-γ2 (PLCG2) 基因中获得的突变很少见. 然而,这些突变在接受伊布鲁替尼治疗的复发性/耐药性CLL患者中更为频繁.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 分子生物学分子生物学
背景情况:
- 布鲁顿氨酸激酶 (BTK) 或脂酶C-γ2 (PLCG2) 中获得的突变与慢性淋巴细胞白血病 (CLL) 用BTK抑制剂治疗的患者的疾病进展有关.
- 有限的数据存在于患者的突变率,这些患者在ibrutinib治疗期间不会发展出进展性疾病.
研究的目的:
- 评估BTK和PLCG2基因突变的频率和时间在患有CLL的患者中.
- 为了比较以前未经治疗和复发/耐药的CLL患者之间的突变率.
主要方法:
- 在五项临床试验中分析了388名先前未经治疗 (n=238) 或复发/耐药 (n=150) CLL 的患者的外周血液样本.
- 随着时间的推移,对患有和没有疾病进展的患者的突变发展的评估.
主要成果:
- 在以前未经治疗的没有进展性疾病 (PD) 的CLL患者中,BTK,PLCG2或组合突变是罕见的 (分别为3%,2%,1%),随访时间中位数为35个月.
- 在没有PD的复发性/耐药性CLL患者中,突变更常见:BTK (30%),PLCG2 (7%),或两者 (5%). 检测BTK C481S的中位时间超过5年.
- 在患有PD的患者中,以前未接受治疗的 (BTK 25%,PLCG2 8%) 与复发/耐药 (BTK 49%,PLCG2 13%) 患者的突变率较低.
结论:
- 这项研究系统地描述了BTK和PLCG2突变随着时间的推移在没有疾病进展的CLL患者中的发展.
- 研究结果为优化治疗效益的潜在策略提供了信息,这些患者在BTK抑制剂上没有表现出进展性疾病.
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