Awidi Abdalla, Abbasi Salah, Alrabi Kamal, Kheirallah Khalid A
Department of Hematology and Oncology, Faculty of Medicine, University of Jordan, Al-Jubeiha, Amman, Jordan.
Department of Internal Medicine, Hematology and Oncology, King Hussein Cancer Center, Al-Jubeiha, Amman, Jordan.
Clin Lymphoma Myeloma Leuk. 2017 Dec;17(12):e55-e61. doi: 10.1016/j.clml.2017.08.001. Epub 2017 Aug 5.
Generic imatinib therapy is being globally considered owing to cost considerations. However, evidence of its efficacy and safety in Middle Eastern clinical settings is scarce.
The efficacy and safety of generic imatinib (Cemivil) were assessed among Jordanian patients diagnosed with chronic myeloid leukemia using an observational, multicenter, prospective study design. Responses were defined using European LeukemiaNet 2009 guidelines and assessed by complete blood counts, fluorescence in situ hybridization, and real-time quantitative polymerase chain reaction.
All patients (N = 91) were adults with chronic myeloid leukemia treated with generic imatinib 400 mg/day. Thirty-three patients received generic imatinib as first-line therapy, and 58 switched from patented imatinib to generic imatinib after a median of 4.5 years (range, 0.5-13.6 years) of imatinib therapy. The majority (85%; n = 28) of the first-line patients achieved complete hematologic response within 3 months of starting generic imatinib therapy (100% after 6 months [n = 33]). The 12-month major molecular response rate in the intention-to-treat population was 45%. The 12-month major molecular response rate was 88% for patients who switched therapy. The 12-month progression-free and overall survival rates were 92% and 100%, respectively. Most (85%; n = 144) adverse events were mild. Frequencies of drug-related adverse events were similar to patented imatinib.
This study suggests that the efficacy and safety of generic imatinib in this Middle Eastern population in routine clinical practice are comparable to patented imatinib, and to that of the global population.
出于成本考虑,全球都在考虑使用伊马替尼仿制药进行治疗。然而,在中东临床环境中其疗效和安全性的证据却很少。
采用观察性、多中心、前瞻性研究设计,评估了约旦慢性髓性白血病患者使用伊马替尼仿制药(Cemivil)的疗效和安全性。依据欧洲白血病网络2009年指南定义反应,并通过全血细胞计数、荧光原位杂交和实时定量聚合酶链反应进行评估。
所有患者(N = 91)均为成年慢性髓性白血病患者,接受每日400毫克伊马替尼仿制药治疗。33例患者接受伊马替尼仿制药作为一线治疗,58例在接受了中位时间为4.5年(范围0.5 - 13.6年)的专利伊马替尼治疗后转用伊马替尼仿制药。大多数(85%;n = 28)一线患者在开始伊马替尼仿制药治疗后3个月内实现了完全血液学缓解(6个月时为100% [n = 33])。意向性治疗人群的12个月主要分子反应率为45%。转用治疗的患者12个月主要分子反应率为88%。12个月无进展生存率和总生存率分别为92%和100%。大多数(85%;n = 144)不良事件为轻度。药物相关不良事件的发生率与专利伊马替尼相似。
本研究表明,在常规临床实践中,伊马替尼仿制药在中东人群中的疗效和安全性与专利伊马替尼相当,且与全球人群的情况类似。