重新审视慢性髓性白血病治疗中的六种既定实践
Hagop M Kantarjian1, Mary Alma Welch1, Elias Jabbour1
1Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
The Lancet. Haematology
|August 31, 2023
概括
治疗慢性髓性白血病 (CML) 的低剂量氨酸激酶抑制剂 (TKIs) 可能具有相似的疗效,但毒性和成本较低. 对于许多具有通用TKI的患者来说,可以实现无治疗缓解,改善长期结果.
科学领域:
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 慢性髓性白血病 (CML) 的治疗依赖于BCR::ABL1氨酸激酶抑制剂 (TKIs).
- 已建立的TKI治疗实践要求在使用20年后分析风险和益处.
研究的目的:
- 分析慢性阶段CML中已建立的BCR::ABL1 TKI治疗实践的风险和益处.
- 建议优化TKI剂量策略,以改善患者的治疗结果和成本效益.
主要方法:
- 这一观点分析了关于TCI疗效,毒性和CML管理成本的现有数据.
- 它审查了治疗指南和患者对各种TKI剂量和切换策略的反应.
主要成果:
- 较低的TKI剂量可以保持治疗疗效,同时降低毒性并改善遵守.
- 仅仅为了更深层次的分子反应而切换TKI可能没有好处,可能会增加危害.
- 通用TKIs提供负担得起,有效的治疗,可能导致30-50%的患者无需治疗的缓解.
结论:
- 优化TKI剂量和明智的TKI选择对于管理CML至关重要.
- 对于大多数CML患者来说,通用TKIs是一个有价值,具有成本效益的选择.
- 高成本的TKI需要根据治疗价值对干细胞移植等替代方案进行批判性评估.
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