Ibrutinib (PCI-32765), the first BTK (Bruton's tyrosine kinase) inhibitor in clinical trials.

Ibrutinib (PCI-32765), the first BTK (Bruton's tyrosine kinase) inhibitor in clinical trials.
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DOI:
10.1007/s11899-012-0147-9
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发表时间:
2013-03
影响因子:
2.9
通讯作者:
Brown, Jennifer R.
Brown, Jennifer R.
中科院分区:
医学3区
文献类型:
--
作者:
Brown, Jennifer R.

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伊布替尼是一种有效的共价激酶抑制剂,靶向BTK。BTK或布鲁顿酪氨酸激酶是治疗B细胞疾病的明显靶点,因为失活突变导致人类B细胞发育不全和X连锁无丙种球蛋白血症疾病。伊布替尼在体外对CLL细胞具有适度的细胞毒性,但也阻断来自微环境的营养刺激。与BCR途径的其他抑制剂一样,伊布替尼引起淋巴结快速减少和与淋巴细胞增多相关的反应,然后随时间恢复至基线。在复发性难治性CLL中,15个月时伊鲁替尼的ORR为67%,PFS为88%。在65岁及以上未接受治疗的患者队列中,估计15个月PFS为96%。注册试验已经启动,剩下的困难任务是确定在CLL治疗过程中这种药物将对患者产生最大的影响和益处。
Ibrutinib is a potent covalent kinase inhibitor that targets BTK. BTK, or Bruton’s tyrosine kinase, is an obvious target for therapy of B cell diseases because inactivating mutations lead to B cell aplasia in humans and the disease X-linked agammaglobulinemia. Ibrutinib has modest cytotoxicity against CLL cells in vitro but also blocks trophic stimuli from the microenvironment. As with other inhibitors of the BCR pathway, ibrutinib causes rapid nodal reduction and response associated with rapid increase in lymphocytosis, which then returns to baseline over time. The ORR of ibrutinib in relapsed refractory CLL is 67 % with PFS 88 % at 15 months. In a cohort of untreated patients 65 years and over, the estimated 15 month PFS is 96 %. Registration trials have been initiated, and the difficult task that remains is to determine where in the course of CLL therapy this drug will have the greatest impact and benefit for patients.
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