在慢性阶段的慢性髓性白血病中优化olverembatinib剂量
Xiaoshuai Zhang1, Yunfan Yang2, Bingcheng Liu3
1Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing.
Haematologica
|April 30, 2025
概括
对慢性髓性白血病 (CML) 患者来说,降低了olverembatinib的初始剂量 (30毫克每隔一天) 与标准的40毫克剂量一样有效. 这种较低的剂量改善了对其他氨酸激酶抑制剂没有反应的患者的耐受性和治疗坚持.
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:
- 优化药物剂量对于平衡癌症治疗中的有效性和安全性至关重要.
- 慢性阶段慢性髓性白血病 (CML) 患者通常需要对氨酸激酶抑制剂 (TKIs) 的剂量进行调整.
研究的目的:
- 为了比较两个olverembatinib剂量 (40 mg QOD vs. 30 mg QOD) 在TKI耐火性CML患者中的安全性和有效性.
- 为了确定降低olverembatinib的初始剂量是否能改善患者的耐受性和治疗坚持性.
主要方法:
- 多中心回顾性研究设计.
- 倾向性得分匹配 (PSM) 以调整基线在队列之间的共同变量.
- 40毫克和30毫克的olverembatinib组之间的细胞遗传/分子反应,结果,剂量坚持和不良事件率的比较.
主要成果:
- 在40毫克和30毫克QOD的olverembatinib剂量组之间,细胞遗传或分子反应没有显著差异.
- 与40毫克QOD剂量相比,在最后的随访中,更高比例的患者保持了原始的30毫克QOD剂量 (64%对44%).
- 在30毫克QOD队列中,由于不良事件导致的剂量减少或永久停药率明显较低 (21%与41%相比).
结论:
- 奥尔韦伦巴替尼布30毫克QOD是慢性阶段CML患者其他TKIs耐药的可行的替代初始剂量.
- 30毫克的QOD起始剂量表现出与40毫克QOD相当的疗效,但具有更好的耐受性和坚持性.
- 优化olverembatinib的剂量可以提高TKI耐火性CML的患者管理.
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