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急性髓系白血病的近期获批疗法:复杂的治疗格局。

Recently approved therapies in acute myeloid leukemia: A complex treatment landscape.

作者信息

Talati Chetasi, Sweet Kendra

机构信息

Department of Malignant Hematology, Moffitt Cancer Center, Tampa, FL, United States.

Department of Malignant Hematology, Moffitt Cancer Center, Tampa, FL, United States.

出版信息

Leuk Res. 2018 Oct;73:58-66. doi: 10.1016/j.leukres.2018.09.001. Epub 2018 Sep 8.

Abstract

Acute myeloid leukemia (AML) is a heterogeneous disease. Until recently, treatment for patients with AML was limited to induction chemotherapy with cytarabine and anthracycline or hypomethylating agents, and, in some instances, allogeneic hematopoietic stem cell transplant. With the recent approval of new therapies-i.e., CPX-351, enasidenib, ivosidenib, gemtuzumab ozogamicin, and midostaurin-a new era in AML treatment has emerged. Comprehensive diagnostic testing, such as cytogenetic and molecular testing, is necessary for establishing patient eligibility for these new agents and should be performed in a timely manner. However, choosing a therapy for patients who are eligible for multiple treatments may be a complex process, particularly for patients with newly diagnosed AML. This review discusses data, including associated safety profiles that supported these recent approvals, and provides insights to help clinicians navigate new therapy options for this devastating disease. Given the heterogeneity of AML, the treatment landscape will likely continue to grow and evolve as additional agents (and their combinations) are approved for the treatment of subpopulations of patients with AML. Physicians will need to remain abreast of the ever-changing treatment landscape.

摘要

急性髓系白血病(AML)是一种异质性疾病。直到最近,AML患者的治疗仅限于使用阿糖胞苷和蒽环类药物或去甲基化药物进行诱导化疗,在某些情况下还包括异基因造血干细胞移植。随着最近新疗法(即CPX-351、恩西地平、艾伏尼布、吉妥珠单抗奥唑米星和米哚妥林)的获批,AML治疗进入了一个新时代。全面的诊断检测,如细胞遗传学和分子检测,对于确定患者是否适合使用这些新药物是必要的,并且应该及时进行。然而,为有多种治疗选择的患者选择治疗方案可能是一个复杂的过程,尤其是对于新诊断的AML患者。本综述讨论了支持这些近期获批药物的数据,包括相关的安全性概况,并提供见解以帮助临床医生为这种毁灭性疾病选择新的治疗方案。鉴于AML的异质性,随着更多药物(及其联合用药)被批准用于治疗AML患者亚群,治疗格局可能会继续发展和演变。医生需要跟上不断变化的治疗格局。

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