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预后标记在向治疗时代的预后标记

Sorang Kang¹, Inhye E Ahn²

¹College of Medicine, Catholic University of Korea, Seoul, Republic of Korea.

Acta haematologica

|September 13, 2023

概括

新的向疗法正在改变慢性淋巴细胞白血病 (CLL) 治疗. 像TP53和IGHV状态这样的遗传标记对于预测布鲁顿氨酸激酶 (BTK) 抑制剂和其他向药物的结果至关重要.

科学领域:

血液学血液学血液学
在瘤学瘤学.
药理学药理学是指药理学的学科.

背景情况:

向疗法,包括布鲁顿的氨酸激酶 (BTK) 抑制剂和B细胞淋巴瘤-2 (BCL-2) 药物,已经取代化疗免疫疗法 (CIT) 作为慢性淋巴细胞白血病 (CLL) 的标准护理.
随着治疗环境的不断变化,需要重新评估CLL个性化药物的预后标志物.
目前正在进行的研究重点是针对性药物组合和基于最小残留疾病 (MRD) 的治疗终止策略.

研究的目的:

在接受向治疗的CLL患者中审查预后标志物.
评估遗传变量对CLL治疗结果的影响.
为 CLL 适应风险的治疗策略的开发提供信息.

主要方法:

审查关于CLL预后标志物的现有文献.
对向疗法和化疗免疫疗法 (CIT) 临床试验数据的分析.
检查基因标记物,如TP53异常,IGHV突变状态和复杂的型.

主要成果:

与CIT相比,BTK抑制剂在TP53-异常的CLL患者中显示出更高的无进展生存率 (PFS) (70%与5年后15%相比).
免疫球蛋白重链可变基因 (IGHV) 突变状态在不同治疗方式 (CIT,venetoclax,BTK抑制剂) 上不同影响PFS和整体存活率.
未变异的IGHV与FCR和固定的持续时间venetoclax的较差结果有关,但不是连续的BTK抑制剂治疗.

结论:

基因变量 (TP53,IGHV,复杂型) 在用向药物治疗的CLL患者中具有显著的预后价值.
了解这些标志物对于定制CLL治疗策略至关重要.
在向性CLL治疗时代,预后标志物评估对于优化风险调整治疗至关重要.

关键词:

慢性淋巴细胞白血病慢性淋巴细胞白血病预测标志物预测标志物有针对性的治疗.

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