Second-generation BCR-ABL inhibitors for frontline treatment of chronic myeloid leukemia in chronic phase.
Second-generation BCR-ABL inhibitors for frontline treatment of chronic myeloid leukemia in chronic phase.
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DOI：
10.1016/j.critrevonc.2011.04.002
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发表时间：
2012-05
期刊：
影响因子：
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通讯作者：
G. Rosti;F. Castagnetti;G. Gugliotta;F. Palandri;M. Baccarani
中科院分区：
文献类型：
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作者：
G. Rosti;F. Castagnetti;G. Gugliotta;F. Palandri;M. Baccarani
最近报道了对新诊断的慢性粒细胞白血病慢性期 (CML-CP) 患者进行的多项关于达沙替尼和尼洛替尼的试验结果，这两种 BCR-ABL 抑制剂与伊马替尼相比具有更高的体外效力。在这篇综述中，讨论了在一线环境中评估达沙替尼和尼洛替尼的基本原理，并总结了迄今为止进行的临床试验的数据，包括与伊马替尼相比的单臂研究和随机试验。总体而言，在治疗的第一年，达沙替尼和尼洛替尼均显示出优于伊马替尼的疗效，需要长期随访以确认这种优势能否随着时间的推移而保持。尽管每种药物都有不同的不良事件模式，但这两种药物也显示出良好的耐受性。临床医生现在有几种有效的选择来治疗新诊断的 CML-CP 患者，现有数据表明，与伊马替尼相比，达沙替尼和尼洛替尼代表了改进的治疗选择。
Results from several trials in patients with newly diagnosed chronic myeloid leukemia in chronic phase (CML-CP) of dasatinib and nilotinib, two BCR-ABL inhibitors with higher in vitro potency compared with imatinib, have recently been reported. In this review, the rationale for assessing dasatinib and nilotinib in the frontline setting is discussed and data from clinical trials performed to date are summarized, including single-arm studies and randomized trials compared with imatinib. Overall, both dasatinib and nilotinib have shown superior efficacy compared with imatinib during the first year of treatment and longer-term follow-up is needed to confirm that this superiority is maintained over time. Both agents have also shown favorable tolerability profiles, although distinct patterns of adverse events are seen with each agent. Clinicians now have several effective options to treat patients newly diagnosed with CML-CP and available data suggest that dasatinib and nilotinib represent improved therapeutic options compared with imatinib.