德维米斯塔特加化疗与单独化疗对于老年复发或耐药AML患者:ARMADA试验结果
Timothy S Pardee1,2, Bayard L Powell1, Richard A Larson3
1Section on Hematology and Oncology, Comprehensive Cancer Center of Atrium Health Wake Forest Baptist, Winston-Salem, NC.
Blood neoplasia
|June 2, 2025
概括
在老年患有复发性或耐药性急性髓性白血病 (AML) 的患者中,德维米斯塔特并没有改善缓解率或生存率. 第三阶段试验发现德维米斯塔特加化疗和单独化疗之间没有显著差异.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 临床试验 临床试验
背景情况:
- 急性髓性白血病 (AML) 在老年人中表现不佳,其特点是耐药性和复发性疾病的高发病率.
- 德维米斯塔特是一种脂酸模拟剂,准线粒体代谢,在早期试验中,当与AML的化疗相结合时,显示出有前途.
研究的目的:
- 评估德维米斯塔特与高剂量细胞氨酸和线粒激素 (CHAM) 结合的疗效和安全性,对老年患有复发性或耐药性AML的患者进行评估.
- 为了比较含有德维米斯塔特的手臂和对照化学疗法方案之间的完全缓解率 (CR) 和整体存活率.
主要方法:
- 第三阶段ARMADA 2000试验随机选择了200名年龄≥50岁的患有复发/耐药AML的患者.
- 患者接受了德维米斯塔特加CHAM或三种控制方案之一,没有德维米斯塔特.
- 评估了安全性和有效性终点,包括CR率和整体存活率.
主要成果:
- 该研究未能达到其主要终点;德维米斯塔特的CR率为20.4%,对照组为21.6% (P=.57).
- 总体存活率没有显著差异,平均存活时间为8.9个月 (德维米斯塔特) 和6.2个月 (对照组) (P=.62).
- 安全性概况与基于高剂量细胞氨酸的救援疗法一致,有9%的患者在研究期间死亡.
结论:
- 在这种患者群体中,将德维米斯塔特添加到高剂量细胞氨酸和线粒中并没有改善完全缓解率或整体存活率.
- 在老年患有复发性或耐药性AML的患者中,德维米斯塔特作为标准救援化疗的补充剂并不有效.
相关概念视频
Treatment Resistant Cancers
3.4K
Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
3.4K
Combination Therapies and Personalized Medicine
5.1K
Combining two or more treatment methods increases the life span of cancer patients while reducing damage to vital organs or tissue from the overuse of a single treatment. Combination therapy also targets different cancer-inducing pathways, thus reducing the chances of developing resistance to treatment.
The combination of the drug acetazolamide and sulforaphane is a good example of combination therapy to treat cancer. The cells in the interior of a large tumor often die due to the hypoxic and...
The combination of the drug acetazolamide and sulforaphane is a good example of combination therapy to treat cancer. The cells in the interior of a large tumor often die due to the hypoxic and...
5.1K
Cancer Therapies
8.0K
Cancer therapies are various modes of treatment, such as surgery, radiation therapy, and chemotherapy that are administered to cancer patients.
However, cancer treatments can pose several challenges, as therapies used to kill cancer cells are generally also toxic to normal cells. Moreover, cancer cells mutate rapidly and can develop resistance to chemical agents or radiation therapy. Besides, all types of cancer cells may not respond to the same therapy. Some cancer cells respond to one...
However, cancer treatments can pose several challenges, as therapies used to kill cancer cells are generally also toxic to normal cells. Moreover, cancer cells mutate rapidly and can develop resistance to chemical agents or radiation therapy. Besides, all types of cancer cells may not respond to the same therapy. Some cancer cells respond to one...
8.0K
Chemotherapy-Induced Nausea and Vomiting: Dopamine Receptor Antagonists
462
Dopamine receptor antagonists, also known as antipsychotic agents, are critical in managing chemotherapy-induced vomiting. These antiemetic agents block dopamine receptors in the chemoreceptor trigger zone (CTZ), inhibiting signal transmission to the vomiting center. Antipsychotic agents encompass phenothiazines (PTZ), butyrophenones, benzamides, and thienobenzodiazepines (Zyprexa), which are utilized for their antiemetic and sedative properties.
Phenothiazines, such as prochlorperazine...
Phenothiazines, such as prochlorperazine...
462
Targeted Cancer Therapies
7.8K
The targeted cancer therapies, also known as “molecular targeted therapies,” take advantage of the molecular and genetic differences between the cancer cells and the normal cells. It needs a thorough understanding of the cancer cells to develop drugs that can target specific molecular aspects that drive the growth, progression, and spread of cancer cells without affecting the growth and survival of other normal cells in the body.
There are several types of targeted therapies against...
There are several types of targeted therapies against...
7.8K
Cancer Survival Analysis
458
Cancer survival analysis focuses on quantifying and interpreting the time from a key starting point, such as diagnosis or the initiation of treatment, to a specific endpoint, such as remission or death. This analysis provides critical insights into treatment effectiveness and factors that influence patient outcomes, helping to shape clinical decisions and guide prognostic evaluations. A cornerstone of oncology research, survival analysis tackles the challenges of skewed, non-normally...
458


