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NICE推荐venetoclax联合阿扎胞苷用于侵袭性血癌患者

2021-12-19 Allan MedSci原创

阿扎胞苷venetoclax治疗
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Venetoclax是一种每日一次的口服疗法，可阻断B细胞淋巴瘤-2蛋白（BCL-2）的作用，该蛋白的存在有助于癌细胞存活。

Venetoclax是一种每日一次的口服疗法，可阻断B细胞淋巴瘤-2蛋白（BCL-2）的作用，该蛋白的存在有助于癌细胞存活。

图.Venetoclax的作用机制

NICE发布了一份积极的最终评估文件，推荐英国NHS常规使用venclyxto（venetoclax）和阿扎胞苷治疗侵袭性急性髓系白血病 (AML)。阿扎胞苷是一种胞苷类似物，阿扎胞苷能直接插入细胞的DNA与RNA中，分别干扰DNA代谢和阻断RNA翻译的过程，从而抑制蛋白质的合成，由此产生细胞毒性，令细胞死亡。

AML 是一种侵袭性和难以治疗的血癌，存活率低。尚不清楚AML 的病因，但增加风险的因素包括以前暴露于非常高水平的辐射，包括以前的放射治疗、以前的化疗、血液疾病或某些遗传疾病，如唐氏综合症和吸烟。该疾病主要影响老年人，由于健康问题和其他条件的存在，大约 40% 的新诊断者无法耐受 IC ​​的标准一线治疗。AML 的中位生存期仅为 6-10 个月。在此期间，患者往往需要住院治疗和频繁输血，对生活质量造成重大影响。

在英国，每年约有 3,200 人被诊断出患有 AML，相当于每天超过 8 例新病例。当强化化疗 (IC) 不适合时，推荐将这种疗法作为成年初治 AML 患者的一种选择。

与单独使用阿扎胞苷治疗相比，NICE 批准联合用药的决定为患者提供了一种治疗选择，可显著提高总生存率、快速和持久缓解率和输血独立性。

Venetoclax 治疗可以在家中进行，减少患者对输血的依赖，并可能意味着更不容易感染冠状病毒和就诊次数的减少。

伯明翰大学血液肿瘤学教授 Charlie Craddock 教授分享道：“Venetoclax联合阿扎胞苷是治疗AML 患者的最重要进展，代表了这种常见血癌治疗方法的一个阶段性变化”。

 

原始出处：

https://www.pharmatimes.com/news/nice_recommend_venetoclax_and_azacytidine_for_patients_with_aggressive_blood_cancer_1385470

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    2022-02-27 canlab

    #NET#

    0

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    2022-03-10 医者仁者

    #阿扎胞苷#也将成为血液肿瘤的经典哦#急性髓系白血病#

    0

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    2021-12-21 fusion

    #NICE#

    0

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    2021-12-21 sunyl07

    #侵袭性#

    0

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    2021-12-21 liuhuangbo

    #血癌#

    0

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口服阿扎胞苷维持治疗具有普遍良好的安全性

J Clin Oncol：Eprenetapopt联合阿扎胞苷治疗TP53突变型MDS和AML

Eprenetapopt（APR-246）是一种新型的一类药物，可使p53蛋白重构，并重新激活其促凋亡和细胞周期阻滞的功能

JCO：口服阿扎胞苷对低风险骨髓增生异常综合征患者的影响

Journal of Clinical Oncology近日发表了一篇研究。结果显示，CC-486虽然可以增加LR-MDS患者不依赖红细胞输血比例，但可能会增加患者早死风险。

拓展阅读

Lancet Haematol：小剂量阿扎胞苷加venetoclax作为急性髓系白血病强化或低强度诱导后的维持治疗

研究也首次证明了在强化诱导后，低剂量氮杂胞苷加venetoclax治疗急性髓系白血病是一种可行且安全的维持治疗策略。

Eur Rev Med Pharmacol Sci：venetoclax联合去甲基化药物治疗老年急性髓系白血病的疗效和安全性：系统性综述和荟萃分析

对于老年AML患者来说，venetoclax联合去甲基化药物疗效显著，且不良事件发生率低，耐受性好。

Lancet Oncol：慢性淋巴细胞白血病三联一线疗法：Acalabrutinib+Venetoclax+Obinutuzumab！

Acalabrutinib、维奈托克和奥比妥珠单抗三联疗法是慢性淋巴细胞白血病的一种高活性且耐受性良好一线疗法

J Clin Oncol：Venetoclax+达雷木单抗+地塞米松±硼替佐米可有效治疗复发/难治性多发性骨髓瘤！

Venetoclax+达雷木单抗+地塞米松±硼替佐米可有效治疗复发/难治性多发性骨髓瘤

Lancet Haematol：Venetoclax联合强化化疗治疗AML或高危MDS的效果

对于新确诊的急性髓系白血病或高风险骨髓增生异常综合征患者，在强化化疗方案中加入Venetoclax是安全且有效的，可产生高比率的持久MRD阴性缓解，并提高无事件生存率和总生存率

Cancer Discov：Venetoclax+Navitoclax+化疗治疗复发/难治性急性淋巴细胞白血病和淋巴母细胞淋巴瘤

复发性/难治性急性淋巴细胞白血病和前体B/T细的预后仍差强人意，新治疗方法是否可带来令人满意的疗效呢？