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J Clin Oncol:BTK抑制剂伊布替尼在复发难治B细胞恶性肿瘤患者中具有显著的抗肿瘤活性

2017-10-17 梅斯医学 梅斯医学

研究背景•BCR在B细胞肿瘤的发生和发展中发挥重要作用,而BTK是BCR信号通路中的调节酶 •BTK是唯一具有吸引力的选择性抑制B细胞的靶点 •伊布替尼是BTK小分子抑制剂,通过具有活性的结合率抑制BCR信号通路研究目的•通过剂量递增试验中确定伊布替尼在复发/难治性B细胞非霍奇金淋巴瘤和CLL/SLL患者中的剂量,安全性,药代动力学,药效学和缓解率特点研究方法•研究设计:•评估

研究背景

•BCR在B细胞肿瘤的发生和发展中发挥重要作用,而BTK是BCR信号通路中的调节酶 

•BTK是唯一具有吸引力的选择性抑制B细胞的靶点 

•伊布替尼是BTK小分子抑制剂,通过具有活性的结合率抑制BCR信号通路

研究目的

•通过剂量递增试验中确定伊布替尼在复发/难治性B细胞非霍奇金淋巴瘤和CLL/SLL患者中的剂量,安全性,药代动力学,药效学和缓解率特点

研究方法

•研究设计:

4-1.png

评估指标:外周血单核细胞(PBMCs) 中伊布替尼与BTK结合情况、缓解率和安全性

研究结果

•伊布替尼1.25mg/kg剂量给药导致与BTK不能完全结合

4-2.png

•伊布替尼2.5mg/kg为最小有效剂量,可导致约20%患者剂量不足

4-3.png

研究结果


•伊布替尼560mg一天一次为淋巴瘤最佳治疗剂量

4-4.png

•伊布替尼不同剂量下BTK结合率不同,420mg是CLL/SLL最佳剂量

4-5.png

研究结果

•伊布替尼与BTK结合作用可维持24小时,一天一次给药缓解率高

4-6.png

•伊布替尼治疗达到既定疗效获益的患者应持续给药

4-7.png

研究结果

•最大耐受剂量(MTD)未达到,不良事件多为1或2级,3,4级罕见,无剂量依赖性 

•常见不良事件为腹泻、恶心/呕吐、疼痛、食欲下降等

研究启示

•是一项评估伊布替尼治疗复发/难治性B细胞肿瘤的剂量、安全性研究 

•伊布替尼2.5mg/kg剂量给药作为最小有效剂量,420mgCLL/SLL最佳剂量 

•伊布替尼与BTK结合作用可维持24小时,一天一次,一次3粒给药缓解率高 

•伊布替尼治疗达到既定疗效获益患者应持续给药 

•伊布替尼治疗不良事件多为1或2级,3,4级罕见,无剂量相关性

如需了解更多淋巴瘤的前沿信息 请扫描二维码访问淋巴瘤亿刻网站。

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time=2017-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1506211, encodeId=ecd61506211f0, content=<a href='/topic/show?id=dcc7384545' target=_blank style='color:#2F92EE;'>#B细胞恶性肿瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3845, encryptionId=dcc7384545, topicName=B细胞恶性肿瘤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55409728490, createdName=chenzhuanggui, createdTime=Thu Oct 19 07:38:00 CST 2017, time=2017-10-19, status=1, ipAttribution=)]
    2017-12-15 jklm09
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time=2017-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1506211, encodeId=ecd61506211f0, content=<a href='/topic/show?id=dcc7384545' target=_blank style='color:#2F92EE;'>#B细胞恶性肿瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3845, encryptionId=dcc7384545, topicName=B细胞恶性肿瘤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55409728490, createdName=chenzhuanggui, createdTime=Thu Oct 19 07:38:00 CST 2017, time=2017-10-19, status=1, ipAttribution=)]
    2018-03-10 minlingfeng
  4. 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time=2017-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1506211, encodeId=ecd61506211f0, content=<a href='/topic/show?id=dcc7384545' target=_blank style='color:#2F92EE;'>#B细胞恶性肿瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3845, encryptionId=dcc7384545, topicName=B细胞恶性肿瘤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55409728490, createdName=chenzhuanggui, createdTime=Thu Oct 19 07:38:00 CST 2017, time=2017-10-19, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1851548, encodeId=5c1e1851548d2, content=<a href='/topic/show?id=f0a254918f0' target=_blank style='color:#2F92EE;'>#抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54918, encryptionId=f0a254918f0, topicName=抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Fri Dec 15 03:38:00 CST 2017, time=2017-12-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2046412, encodeId=fcaf2046412c2, content=<a href='/topic/show?id=830c4258913' target=_blank style='color:#2F92EE;'>#复发难治#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42589, encryptionId=830c4258913, topicName=复发难治)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=02f5179, 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time=2017-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1506211, encodeId=ecd61506211f0, content=<a href='/topic/show?id=dcc7384545' target=_blank style='color:#2F92EE;'>#B细胞恶性肿瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3845, encryptionId=dcc7384545, topicName=B细胞恶性肿瘤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55409728490, createdName=chenzhuanggui, createdTime=Thu Oct 19 07:38:00 CST 2017, time=2017-10-19, status=1, ipAttribution=)]
  6. 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  7. 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