复发性/耐药性多发性骨髓瘤的基于Venetoclax的治疗组合:实践模式和二次细胞遗传异常对结果的影响
Abiola Bolarinwa1, Madhu Nagaraj1, Saurabh Zanwar1
1Division of Hematology, Mayo Clinic, Rochester, MN, USA.
Blood cancer journal
|April 4, 2025
概括
威尼托克拉克斯在复发性/耐药性多发性骨髓瘤 (RRMM) 患者中表现出有效性,患有t 然而,在缺乏这种遗传标记物的患者中,它的有效性是有限的,特别是高风险细胞遗传学.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 临床药理学 临床药理学
背景情况:
- 作为BCL-2抑制剂的Venetoclax (Ven) 在复发性/耐药性多发性骨髓瘤 (RRMM) 中表现有前途.
- 临床试验数据对Ven的疗效,特别是在特定的遗传子集,如t(11;14),仍然是不确定的.
- 了解Venetoclax在不同RRMM患者群体中的实际有效性至关重要.
研究的目的:
- 评估基于Venetoclax的疗法的疗效和安全性,在没有AL氨基粉症的RRMM患者中.
- 评估t(11;14) 转位和BCL-2表达对治疗结果的影响.
- 确定影响维内托克拉克斯反应和无进展生存的因素,包括细胞遗传异常.
主要方法:
- 从2015年1月到2023年12月,对232名RRMM患者进行了回顾性分析,这些患者接受了Venetoclax组合治疗.
- 基于t(11;14) 状态和评估BCL-2表达的患者分层.
- 对治疗方案 (Ven-Dex,PI-Ven,Daratumumab-Ven) 的分析和整体应答率 (ORR) 和无进展生存时间 (PFS) 的评估.
主要成果:
- 总体应答率为57%,t(11;14) 患者的ORR (64%) 与非t(11;14) 患者 (26%) 相比显著更高.
- 中位数的PFS总体为9.4个月,对于t(11;14) 患者为11.8个月,对于非t(11;14) 患者为2.9个月 (p < 0.001).
- 在t(11;14) 患者中,高风险细胞遗传学 (del(17p) 或1q增益/放大) 将PFS降低到7.7个月.
结论:
- 基于Venetoclax的疗法是RRMM患者具有t(11;14) 转位的重要治疗选择.
- 在没有t的RRMM患者中,Venetoclax的有效性是有限的.
- 在接受Venetoclax的患者中,二次高风险细胞遗传异常显著损害了PFS.
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