Minotti Giorgio, Han Haiyong, Cattan Valérie, Egorov Anton, Bertoni Francesco
a Department of Medicine and Unit for Drug Sciences , University Campus Bio-Medico , Rome , Italy.
b Molecular Medicine Division , Translational Genomics Research Institute , Phoenix , AZ , USA.
Expert Rev Hematol. 2018 Jul;11(7):587-596. doi: 10.1080/17474086.2018.1476848. Epub 2018 Jun 18.
Pixantrone is a first-in-class aza-anthracenedione approved as monotherapy for treatment of relapsed or refractory aggressive diffuse B-cell non-Hodgkin's lymphoma (NHL), a patient group which is notoriously difficult to treat. It has a unique chemical structure and pharmacologic properties distinguishing it from anthracyclines and anthracenediones. Areas covered: The chemical structure and mode of action of pixantrone versus doxorubicin and mitoxantrone; preclinical evidence for pixantrone's therapeutic effect and cardiac tolerability; efficacy and safety of pixantrone in clinical trials; ongoing and completed trials of pixantrone alone or as combination therapy; and the risk of cardiotoxicity of pixantrone versus doxorubicin and mitoxantrone. Expert commentary: Currently, pixantrone is the only approved therapy for multiply relapsed or refractory NHL, an area with few available effective treatment options. Pixantrone is currently being investigated as combination therapy with other drugs including several targeted therapies, with the ultimate goal of improved survival in heavily pretreated patients. In order for pixantrone to be acknowledged in the treatment of aggressive NHL, the perception of pixantrone as an anthracycline-like agent that has anthracycline-like activity and cardiotoxicity needs to be changed. Further data from ongoing clinical trials will help in confirming pixantrone as an effective and safe option.
匹杉琼是首个获批的氮杂蒽二酮类药物，被批准作为单一疗法用于治疗复发或难治性侵袭性弥漫性B细胞非霍奇金淋巴瘤（NHL），这是一个众所周知难以治疗的患者群体。它具有独特的化学结构和药理特性，使其有别于蒽环类药物和蒽二酮类药物。涵盖领域：匹杉琼与阿霉素和米托蒽醌相比的化学结构和作用方式；匹杉琼治疗效果和心脏耐受性的临床前证据；匹杉琼在临床试验中的疗效和安全性；匹杉琼单独或作为联合疗法的正在进行和已完成的试验；以及匹杉琼与阿霉素和米托蒽醌相比的心脏毒性风险。专家评论：目前，匹杉琼是唯一获批用于多次复发或难治性NHL的疗法，这是一个有效治疗选择很少的领域。匹杉琼目前正在作为与其他药物（包括几种靶向疗法）的联合疗法进行研究，最终目标是提高经过大量预处理患者的生存率。为了使匹杉琼在侵袭性NHL的治疗中得到认可，需要改变将匹杉琼视为具有蒽环类活性和心脏毒性的类似蒽环类药物的观念。正在进行的临床试验的进一步数据将有助于确认匹杉琼是一种有效且安全的选择。
