Russell-Smith T Alexander, Gurskyte Laura, Muresan Bogdan, Mamolo Carla M, Gezin Ana, Cappelleri Joseph C, Heeg Bart
Pfizer, Inc., New York, NY 10017, USA.
Ingress Health, a company of Cytel, Weena 316-318, 3012 NJ, Rotterdam, The Netherlands.
Future Oncol. 2022 May;18(16):2029-2039. doi: 10.2217/fon-2021-1355. Epub 2022 Feb 24.
relapsed and/or refractory acute myeloid leukemia (rrAML) has limited treatment options for patients not eligible ('unfit') to receive intensive chemotherapy-based interventions. The authors aimed to summarize outcomes for licensed therapies in this setting. A systematic literature review identified licensed therapies in this setting. A feasibility assessment was made to conduct a network meta-analysis to evaluate comparative efficacy. Seven unique trials were identified. Median survival months were 13.8 for gemtuzumab ozogamicin (GO), 9.3 for gilteritinib (FLT3 mutated rrAML), 5.6 for low-dose cytarabine and 3.2 for best supportive care; transplant rates with gilteritinib and GO were 25.5 and 19%, respectively. A network meta-analysis was not feasible. There remains a high unmet need in rrAML patients not eligible for intensive therapy, with GO and gilteritinib (only FLT3-mutated AML) providing the best current options.
对于不符合条件(“不适合”)接受强化化疗干预的复发和/或难治性急性髓系白血病(rrAML)患者,治疗选择有限。作者旨在总结在这种情况下已获许可疗法的治疗结果。一项系统的文献综述确定了这种情况下的已获许可疗法。进行了可行性评估以开展网络荟萃分析,以评估比较疗效。共确定了7项独特的试验。吉妥单抗奥佐米星(GO)的中位生存月数为13.8个月,吉列替尼(FLT3突变的rrAML)为9.3个月,小剂量阿糖胞苷为5.6个月,最佳支持治疗为3.2个月;使用吉列替尼和GO的移植率分别为25.5%和19%。进行网络荟萃分析不可行。对于不符合强化治疗条件的rrAML患者,仍有很大的未满足需求,GO和吉列替尼(仅适用于FLT3突变的AML)是目前最佳的选择。