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达沙替尼

Dasatinib.

作者信息

Lindauer Markus, Hochhaus Andreas

机构信息

Medizinische Klinik III, SLK-Kliniken Heilbronn GmbH, Am Gesundbrunnen 20-26, Heilbronn, 74078, Germany.

出版信息

Recent Results Cancer Res. 2010;184:83-102. doi: 10.1007/978-3-642-01222-8_7.

Abstract

Dasatinib, (former BMS 354825), is an orally available small-molecule multikinase inhibitor. It potently inhibits BCR-ABL and SRC-family kinases (SRC, LCK, YES, FYN), but also c-KIT, PDGFR-alpha and beta, and ephrin receptor kinase.Dasatinib is about 300 times more potent than imatinib in cells expressing unmutated BCR-ABL in vitro. The drug has demonstrated activity against clinically relevant mutations, including those associated with poor prognosis during ongoing imatinib therapy.Dasatinib is approved for the treatment of patients with BCR-ABL-positive chronic myeloid leukemia (CML), resistant or intolerant to imatinib in chronic, accelerated, and blast phase. It also is approved for the treatment of Philadelphia Chromosome positive (Ph+) acute lymphoblastic leukemia (ALL) resistant or intolerant to imatinib.A single daily dose of 100 mg in chronic phase CML results in high hematologic and molecular remission rates and prolongation of survival. In accelerated and blastic phase as well as in ALL, 70 mg twice daily is recommended. Complete hematologic and cytogenetic remissions (CR) frequently occur even in this patient group with poor prognosis. Remissions however are very short.Side effects of dasatinib are frequent but mostly moderate and manageable and include cytopenias and pleural effusions. The role of dasatinib in other diseases, including solid tumors, has to be identified.

摘要

达沙替尼(原BMS 354825)是一种口服有效的小分子多激酶抑制剂。它能有效抑制BCR-ABL和SRC家族激酶(SRC、LCK、YES、FYN),还能抑制c-KIT、血小板衍生生长因子受体α和β以及 Ephrin受体激酶。在体外表达未突变BCR-ABL的细胞中,达沙替尼的效力比伊马替尼高约300倍。该药物已显示出对临床相关突变的活性,包括与伊马替尼持续治疗期间预后不良相关的突变。达沙替尼被批准用于治疗对伊马替尼耐药或不耐受的慢性期、加速期和急变期BCR-ABL阳性慢性髓性白血病(CML)患者。它也被批准用于治疗对伊马替尼耐药或不耐受的费城染色体阳性(Ph+)急性淋巴细胞白血病(ALL)。慢性期CML患者每日单次服用100 mg可导致高血液学和分子缓解率并延长生存期。在加速期和急变期以及ALL中,推荐每日两次服用70 mg。即使在这个预后较差的患者群体中,也经常出现完全血液学和细胞遗传学缓解(CR)。然而,缓解期非常短。达沙替尼的副作用很常见,但大多为中度且可控,包括血细胞减少和胸腔积液。达沙替尼在其他疾病(包括实体瘤)中的作用有待确定。

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