Division of Hematology/Oncology, Department of Internal Medicine, University of Michigan Cancer Center, Ann Arbor, Michigan.
Department of Clinical and Biological Sciences, University of Turin, San Luigi Hospital, Orbassano-Torino, Italy.
Cancer. 2018 Apr 15;124(8):1660-1672. doi: 10.1002/cncr.31232. Epub 2018 Jan 25.
Chronic myeloid leukemia (CML) has evolved into a chronic disease that is managed with tyrosine kinase inhibitor therapy. Now that long-term survival has been achieved in patients with CML, the focus of treatment has shifted to dose optimization, with the goal of maintaining response while improving quality of life. In this review, the authors discuss optimizing the dose of the second-generation tyrosine kinase inhibitor dasatinib. Once-daily dosing regimens for dasatinib in the first and later lines of treatment were established through long-term (5-year and 7-year) trials. Recently published data have indicated that further dose optimization may maintain efficacy while minimizing adverse events. Results obtained from dose optimization and discontinuation trials currently in progress will help practitioners determine the best dose and duration of dasatinib for patients with CML, because treatment decisions will be made through continued discussions between physicians and patients. Cancer 2018;124:1660-72. © 2018 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
慢性髓性白血病(CML)已发展成为一种可通过酪氨酸激酶抑制剂治疗来控制的慢性疾病。由于 CML 患者已经实现了长期生存,因此治疗的重点已经转移到剂量优化上,目标是在提高生活质量的同时保持疗效。在这篇综述中,作者讨论了优化第二代酪氨酸激酶抑制剂达沙替尼的剂量。达沙替尼在一线和二线治疗中的每日一次给药方案是通过长期(5 年和 7 年)试验确定的。最近公布的数据表明,进一步的剂量优化可能在最小化不良事件的同时保持疗效。目前正在进行的剂量优化和停药试验的结果将有助于临床医生确定达沙替尼治疗 CML 患者的最佳剂量和持续时间,因为治疗决策将通过医生和患者之间的持续讨论来做出。癌症 2018;124:1660-72。©2018 作者。癌症由 Wiley Periodicals, Inc. 代表美国癌症协会出版。这是在知识共享署名-非商业性使用许可下的许可协议下授予的,允许在任何媒体中使用、分发和复制原始作品,只要原始作品正确引用且不用于商业目的。