Mukherji Deborah, Pettengell Ruth
Medical Oncology, St. Georges Hospital, London, UK.
Drugs Today (Barc). 2009 Nov;45(11):797-805. doi: 10.1358/dot.2009.45.11.1438459.
Pixantrone (BBR-2778) is a novel aza-anthracenedione anthracycline derivative developed by Cell Therapeutics Incorporated, WA, USA. Pixantrone is similar in structure to the anthracenedione mitoxantrone but lacks the 5, 8-dihydroxy substitution groups implicated in mitoxantrone-induced cardiotoxicity. The PIX301 phase III single-agent trial of pixantrone for patients with relapsed or refractory aggressive non-Hodgkin's lymphoma randomized patients to receive either pixantrone or another single agent of the investigators' choice. The rate of confirmed and unconfirmed remissions in patients treated with pixantrone was significantly higher than in those receiving other agents, as was the overall response rate and progression-free survival. There is evidence that pixantrone is well tolerated when substituted for anthracyclines in combination regimens for aggressive non-Hodgkin's lymphoma with comparable rates of complete remission. Pixantrone has also been used for the treatment of indolent non-Hodgkin's lymphomas and the combination of pixantrone and rituximab has been shown to be superior to rituximab alone in relapsed or refractory disease in the phase III PIX302 study. On the basis of these data, the United States Food and Drug Administration is considering pixantrone for use in adult patients with relapsed or refractory aggressive and indolent non-Hodgkin's lymphoma on a fast-track basis.
匹杉琼（BBR-2778）是美国华盛顿州细胞治疗公司研发的一种新型氮杂蒽二酮蒽环类衍生物。匹杉琼在结构上与蒽二酮米托蒽醌相似，但缺乏与米托蒽醌诱导的心脏毒性相关的5,8-二羟基取代基。针对复发或难治性侵袭性非霍奇金淋巴瘤患者的匹杉琼PIX301 III期单药试验将患者随机分组，分别接受匹杉琼或研究者选择的另一种单药治疗。接受匹杉琼治疗的患者中，确认和未确认的缓解率显著高于接受其他药物治疗的患者，总缓解率和无进展生存期也是如此。有证据表明，在侵袭性非霍奇金淋巴瘤联合治疗方案中，用匹杉琼替代蒽环类药物时耐受性良好，完全缓解率相当。匹杉琼也已用于治疗惰性非霍奇金淋巴瘤，在III期PIX302研究中，匹杉琼与利妥昔单抗联合使用在复发或难治性疾病中已显示出优于单独使用利妥昔单抗。基于这些数据，美国食品药品监督管理局正在考虑对复发或难治性侵袭性和惰性非霍奇金淋巴瘤成年患者快速批准使用匹杉琼。
