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Blood:依鲁替尼联合利妥昔单抗与依鲁替尼单药治疗慢性淋巴细胞白血病的效果对比

2018-12-08 MedSci MedSci原创

中心点:依鲁替尼加利妥昔单抗治疗复发性和未治疗过的高风险的CLL患者,并未提高PFS.依鲁替尼联合利妥昔单抗治疗的患者更快地获得缓解,显着减少残余病灶。摘要:依鲁替尼,一种口服的Bruton酪氨酸激酶(BTK)共价抑制剂,可有效治疗CLL。利妥昔单抗能否在依鲁替尼的基础上锦上添花?Jan A. Burger等人对此展开研究。研究人员招募了208位CLL患者(181位复发性CLL患者,27位未治疗过

中心点:

依鲁替尼加利妥昔单抗治疗复发性和未治疗过的高风险的CLL患者,并未提高PFS.

依鲁替尼联合利妥昔单抗治疗的患者更快地获得缓解,显着减少残余病灶。

摘要:

依鲁替尼,一种口服的Bruton酪氨酸激酶(BTK)共价抑制剂,可有效治疗CLL。利妥昔单抗能否在依鲁替尼的基础上锦上添花?Jan A. Burger等人对此展开研究。

研究人员招募了208位CLL患者(181位复发性CLL患者,27位未治疗过的高风险疾病患者[del17p或TP53突变),将其随机均分至依鲁替尼单药组(420mg,1/日,28天一疗程)和联合利妥昔单抗组(利妥昔单抗 375MG/m2,第一疗程 1次/周,随后5个疗程 1次/疗程)。主要结点是无进展存活期(PFS)。

中位随访36个月,单药组和联合组的PFS分别是86%(95% CI 76.6-91.9)和86.9%(77.3-92.6)。两个治疗臂的缓解率相差无几*总体缓解率92%。但是,联合组外周血淋巴细胞计数恢复正常的时间和获得完全缓解的时间都缩短,骨髓中残余病灶水平也有所降低。

总体来看,依鲁替尼添加利妥昔单治疗复发的、未治疗过的复发性高风险CLL患者,不能提高其PFS。但依鲁替尼联合利妥昔单抗治疗,患者可快速获得缓解,残余病灶水平也明显减轻。

综上所述,依鲁替尼单药仍然是目前CLL的标准疗法。


原始出处:

Jan A. Burger,et al. Randomized trial of ibrutinib versus ibrutinib plus rituximab in patients with chronic lymphocytic leukemia. Blood  2018  :blood-2018-10-879429;  doi: https://doi.org/10.1182/blood-2018-10-879429

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    2018-12-08 医者仁心5538

    学习了

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1997927, encodeId=6e6a199e92756, content=<a href='/topic/show?id=75ff66001cd' target=_blank style='color:#2F92EE;'>#淋巴细胞白血病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66001, encryptionId=75ff66001cd, topicName=淋巴细胞白血病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1be8234, createdName=sunyl07, createdTime=Tue Apr 16 01:11:00 CST 2019, time=2019-04-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1660452, encodeId=c946166045222, content=<a href='/topic/show?id=c0de32285a1' target=_blank style='color:#2F92EE;'>#利妥昔#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32285, encryptionId=c0de32285a1, topicName=利妥昔)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a58d25117340, createdName=花花1374, createdTime=Mon Aug 05 03:11:00 CST 2019, time=2019-08-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1687720, encodeId=a881168e72011, content=<a href='/topic/show?id=be223633375' target=_blank style='color:#2F92EE;'>#单药治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36333, encryptionId=be223633375, topicName=单药治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2bef28414326, createdName=12498717m75(暂无昵称), createdTime=Tue Jan 22 01:11:00 CST 2019, time=2019-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1302218, encodeId=421c13022185e, content=<a href='/topic/show?id=82a6659902c' target=_blank style='color:#2F92EE;'>#淋巴细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65990, encryptionId=82a6659902c, topicName=淋巴细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e34303, createdName=wetgdt, createdTime=Mon Dec 10 05:11:00 CST 2018, time=2018-12-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=354823, encodeId=1d3335482363, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82311653708, createdName=医者仁心5538, createdTime=Sat Dec 08 17:29:10 CST 2018, time=2018-12-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046688, encodeId=58d81046688ae, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Sat Dec 08 17:11:00 CST 2018, time=2018-12-08, status=1, ipAttribution=)]
    2018-12-08 CHANGE

    疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的

    0

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