Hofstra North Shore-LIJ School of Medicine, Department of Medicine, Division Hematology-Oncology, CLL Research and Treatment Program , 410 Lakeville Road Suite 212, New Hyde Park, NY 11042, USA.
Leuk Lymphoma. 2013 Aug;54(8):1817-20. doi: 10.3109/10428194.2013.796049.
New treatment options are urgently needed for patients with relapsed chronic lymphocytic leukemia (CLL) who fail to respond to currently available therapies or cannot achieve a sustained response. Moreover, targeted agents with less myelotoxicity are necessary to treat patients with multiple comorbidities who would otherwise be unable to tolerate standard regimens. Ibrutinib, a Bruton's tyrosine kinase inhibitor, has shown highly encouraging results in phase I/II trials in patients with treatment-naive, relapsed and refractory CLL even in the presence of high risk disease or poor prognostic markers. In phase I/II trials, ibrutinib 420 mg or 840 mg - given continuously as single agent or at a dose of 420 mg daily in combination with a monoclonal antibody or chemoimmunotherapy - has been associated with high response rates and durable clinical remissions. Phase II and III trials are currently under way for treatment-naive patients, relapsed/refractory patients, and for those patients harboring a 17p deletion.
对于那些对现有治疗方法无反应或无法获得持续缓解的复发慢性淋巴细胞白血病 (CLL) 患者，迫切需要新的治疗选择。此外，对于患有多种合并症的患者，需要使用毒性较小的靶向药物，否则这些患者将无法耐受标准治疗方案。布鲁顿酪氨酸激酶抑制剂伊布替尼在初治、复发和难治性 CLL 患者的 I/II 期试验中取得了令人鼓舞的结果，即使患者存在高危疾病或预后不良标志物。在 I/II 期试验中，伊布替尼 420mg 或 840mg-作为单一药物连续使用或每日 420mg 与单克隆抗体或化疗免疫治疗联合使用-与高缓解率和持久的临床缓解相关。目前正在进行 II 期和 III 期试验，用于治疗初治患者、复发/难治性患者以及携带 17p 缺失的患者。
