Do Young Rok, Kwak Jae-Yong, Kim Jeong A, Kim Hyeoung Joon, Chung Joo Seop, Shin Ho-Jin, Kim Sung-Hyun, Bunworasate Udomsak, Choi Chul Won, Zang Dae Young, Oh Suk Joong, Jootar Saengsuree, Reksodiputro Ary Harryanto, Lee Won Sik, Mun Yeung-Chul, Kong Jee Hyun, Caguioa Priscilla B, Kim Hawk, Park Jinny, Kim Dong-Wook
Dongsan Medical Center, Keimyung University, Daegu, South Korea.
Chonbuk National University Medical School & Hospital, Jeonju, South Korea.
Br J Haematol. 2020 Apr;189(2):303-312. doi: 10.1111/bjh.16381. Epub 2020 Feb 3.
In the phase 3 study RERISE, patients with newly diagnosed chronic myeloid leukaemia in chronic phase demonstrated significantly faster and higher rates of major molecular response (MMR) with twice-daily radotinib 300 mg (n = 79) or 400 mg (n = 81) than with once-daily imatinib 400 mg (n = 81) after 12 months. With ≥48 months' follow-up, MMR was higher with radotinib 300 mg (86%) or 400 mg (83%) than with imatinib (75%). Among patients with BCR-ABL1 ≤ 10% at three months, MMR and molecular response 4·5 (MR ) were achieved within 48 months by more radotinib-treated patients (300 mg: 84% and 52%, respectively; 400 mg: 74% and 44%, respectively) than imatinib-treated patients (71% and 44%, respectively). Estimated overall and progression-free survival rates at 48 months were not significantly different between imatinib (94% and 94%, respectively) and radotinib 300 mg (99% and 97%, respectively) or 400 mg (95% and 93%, respectively). The treatment failure rate was significantly higher with imatinib (19%) than with radotinib 300 mg (6%; P = 0·0197) or 400 mg (5%; P = 0·0072). Safety profiles were consistent with previous reports; most adverse events occurred within 12 months. Radotinib continues to demonstrate robust, deep molecular responses, suggesting that treatment-free remission may be attainable.
在3期RERISE研究中,新诊断的慢性期慢性髓性白血病患者接受每日两次300毫克(n = 79)或400毫克(n = 81)的拉多替尼治疗后,12个月时主要分子反应(MMR)的速度明显更快,发生率更高,高于每日一次400毫克伊马替尼(n = 81)组。经过≥48个月的随访,300毫克(86%)或400毫克(83%)拉多替尼组的MMR高于伊马替尼组(75%)。在3个月时BCR-ABL1≤10%的患者中,接受拉多替尼治疗(300毫克组分别为84%和52%;400毫克组分别为74%和44%)并在48个月内实现MMR和分子反应4.5(MR4.5)的患者多于接受伊马替尼治疗的患者(分别为71%和44%)。伊马替尼组(分别为94%和94%)与300毫克拉多替尼组(分别为99%和97%)或400毫克拉多替尼组(分别为95%和93%)在48个月时的总生存率和无进展生存率估计无显著差异。伊马替尼组的治疗失败率(19%)显著高于300毫克拉多替尼组(6%;P = 0.0197)或400毫克拉多替尼组(5%;P = 0.0072)。安全性与既往报告一致;大多数不良事件发生在12个月内。拉多替尼持续显示出强劲、深度的分子反应,提示可能实现无治疗缓解。