Department of Haematology, St Vincent's Hospital, 41 Victoria Parade, Melbourne, Victoria 3065, Australia.
Department of Haematology, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, Victoria 3065, Australia; Department of Medicine, University of Melbourne, 780 Elizabeth Street, Melbourne, Australia.
Hematol Oncol Clin North Am. 2021 Aug;35(4):761-773. doi: 10.1016/j.hoc.2021.03.006. Epub 2021 May 28.
Bruton tyrosine kinase inhibitors have indisputably transformed the treatment landscape of chronic lymphocytic leukemia, but require continuous therapy to maintain response. This places emphasis on their unique toxicity profile and potential loss of efficacy owing to resistance. Data from single-arm clinical studies are suggestive of comparable efficacy and favorable toxicity profiles of next-generation Bruton tyrosine kinase inhibitors. This is supported by the ASPEN study in Waldenstrom's macroglobulinemia, which convincingly demonstrated that zanubrutinib has a better toxicity profile than ibrutinib. Novel, reversible Bruton tyrosine kinase inhibitors are showing the potential to improve long-term efficacy by overcoming common mechanisms of resistance.
布鲁顿酪氨酸激酶抑制剂无疑改变了慢性淋巴细胞白血病的治疗格局，但需要持续治疗来维持疗效。这就强调了它们独特的毒性特征和由于耐药性导致的潜在疗效丧失。来自单臂临床研究的数据表明，新一代布鲁顿酪氨酸激酶抑制剂具有相当的疗效和良好的毒性特征。这得到了 Waldenstrom 巨球蛋白血症中的 ASPEN 研究的支持，该研究令人信服地表明，zanubrutinib 的毒性特征优于伊布替尼。新型、可逆的布鲁顿酪氨酸激酶抑制剂通过克服常见的耐药机制，显示出提高长期疗效的潜力。
