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三期临床试验(RERISE 研究):雷替尼与伊马替尼治疗新诊断慢性期慢性髓性白血病的疗效和安全性比较结果。

Phase III Clinical Trial (RERISE study) Results of Efficacy and Safety of Radotinib Compared with Imatinib in Newly Diagnosed Chronic Phase Chronic Myeloid Leukemia.

机构信息

Chonbuk National University Medical School & Hospital, Jeonju, South Korea.

Dong-A University Medical Center, Busan, South Korea.

出版信息

Clin Cancer Res. 2017 Dec 1;23(23):7180-7188. doi: 10.1158/1078-0432.CCR-17-0957. Epub 2017 Sep 22.

Abstract

Radotinib is a second-generation BCR-ABL1 tyrosine kinase inhibitor (TKI) approved in Korea for chronic phase chronic myeloid leukemia (CML-CP) in patients newly diagnosed or with insufficient response to other TKIs. This study was conducted to evaluate the efficacy and safety of radotinib as first-line therapy for CML-CP. This multinational, open-label study assigned patients (1:1:1) to one of two twice-daily radotinib doses, or imatinib daily. The primary endpoint was major molecular response (MMR) by 12 months. Two hundred forty-one patients were randomized to receive radotinib 300 mg ( = 79) or 400 mg twice-daily ( = 81), or imatinib 400 mg daily ( = 81). MMR rates by 12 months were higher in patients receiving radotinib 300 mg (52%) or radotinib 400 mg twice-daily (46%) versus imatinib (30%; = 0.0044 and = 0.0342, respectively). Complete cytogenetic response (CCyR) rates by 12 months were higher for radotinib 300 mg (91%) versus imatinib (77%; = 0.0120). Early molecular response at 3 months occurred in 86% and 87% of patients receiving radotinib 300 mg and radotinib 400 mg, respectively, and 71% of those receiving imatinib. By 12 months, no patients had progression to accelerated phase or blast crisis. Most adverse events were manageable with dose reduction. Radotinib demonstrated superiority over imatinib in CCyR and MMR in patients newly diagnosed with Philadelphia chromosome-positive CML-CP. This trial was registered at www.clinicaltrials.gov as NCT01511289 .

摘要

罗地替尼是一种第二代 BCR-ABL1 酪氨酸激酶抑制剂(TKI),在韩国被批准用于新诊断或对其他 TKI 反应不足的慢性期慢性髓性白血病(CML-CP)患者。本研究旨在评估罗地替尼作为 CML-CP 一线治疗的疗效和安全性。这项多中心、开放性研究将患者(1:1:1)随机分配至每日两次接受罗地替尼 300mg( = 79)或 400mg( = 81),或每日接受伊马替尼 400mg( = 81)。主要终点为 12 个月时的主要分子学缓解(MMR)。241 例患者被随机分配接受罗地替尼 300mg(52%)或罗地替尼 400mg 每日两次(46%)治疗,或伊马替尼 400mg 每日一次(30%;=0.0044 和=0.0342,分别)。12 个月时,接受罗地替尼 300mg 或罗地替尼 400mg 每日两次治疗的患者 MMR 率高于接受伊马替尼治疗的患者(分别为 91%和 77%;=0.0120)。12 个月时,接受罗地替尼 300mg 治疗的患者完全细胞遗传学缓解(CCyR)率高于接受伊马替尼治疗的患者(86%比 71%;=0.0120)。接受罗地替尼 300mg 和罗地替尼 400mg 治疗的患者分别有 86%和 87%在 3 个月时出现早期分子反应,而接受伊马替尼治疗的患者有 71%出现早期分子反应。至 12 个月时,无患者进展为加速期或急变期。大多数不良事件可通过减少剂量来控制。在新诊断的费城染色体阳性 CML-CP 患者中,罗地替尼在 CCyR 和 MMR 方面优于伊马替尼。该试验在 www.clinicaltrials.gov 注册,编号为 NCT01511289。

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