来自PACE和OPTIC试验的慢性阶段慢性髓性白血病 (CP-CML) 患者中波纳替尼的剂量修改动态
Elias Jabbour1, Jane Apperley2, Jorge Cortes3
1The University of Texas MD Anderson Cancer Center, Houston, TX, USA. ejabbour@mdanderson.org.
Leukemia
|January 29, 2024
概括
波纳替尼有效治疗耐其他药物耐药的慢性髓性白血病 (CML). 与PACE试验相比,OPTIC试验中的新剂量策略降低了心血管风险,改善了患者的安全性.
科学领域:
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
- 血液学 血液学 血液学
背景情况:
- 波纳替尼是第三代氨酸激酶抑制剂 (TKI),向BCR::ABL1,有效治疗耐药慢性髓性白血病 (CML).
- 心血管毒性,如动脉闭塞事件 (AOEs),是已知的TKIs的副作用,包括ponatinib.
研究的目的:
- 为了评估ponatinib的疗效和安全性,使用基于响应的剂量降低策略,在耐多重TKI或T315I突变的CML患者中评估ponatinib的疗效和安全性.
- 为了在PACE和OPTIC试验中比较ponatinib的剂量反应关系和安全概况.
主要方法:
- 在PACE和OPTIC试验中,对在PACE和OPTIC试验中每天服用45毫克波纳替尼的CML患者的结局分析.
- 利用倾向性得分分析来比较两项试验之间的动脉封闭事件 (AOEs).
- 评估生存率和实现BCR的时间:ABL1IS ≤1%.
主要成果:
- 与PACE相比,OPTIC试验的生存率和深度分子响应的时间 (BCR::ABL1IS ≤1%) 在OPTIC试验中类似或改善.
- 患有T315I突变的患者在两项试验中都表现出强大的结局.
- 与PACE试验相比,OPTIC试验显示了较低的暴露调整后AOE发病率.
结论:
- 基于响应的ponatinib剂量策略显著改善了治疗耐受性.
- 这种新的剂量方法有效地减轻了用ponatinib治疗的CML患者的心血管风险.
- 波纳替尼仍然是CML的关键治疗选择,优化剂量可以提高其安全性.
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