Division of Hematology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School; and.
Department of Medical Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
J Natl Compr Canc Netw. 2022 Sep;20(9):1063-1068. doi: 10.6004/jnccn.2022.7026.
Interferons are cytokines with immunomodulatory properties that have been used in the treatment of myeloproliferative neoplasms (MPNs) for decades. However, their widespread use has been hampered by their adverse effect profile and difficulty with administration. Recently there has been a resurgence of interest in the use of interferons in MPNs given the development of pegylated formulations with improved tolerability. Currently, treatments for polycythemia vera (PV) and essential thrombocythemia (ET) are targeted toward decreasing the risk of thrombotic complications, because there are no approved therapies that are known to modify disease. However, recent data on interferons in MPNs have suggested the potential for disease-modifying activity, including the achievement of molecular remission and sustained clinical response. This development has led to the question of whether interferons should move forward as the preferred frontline cytoreductive agent for ET and PV, and challenges the criteria currently used to initiate therapy. We review randomized controlled trial data evaluating interferon's efficacy and tolerability in patients with ET and PV. We then consider the data in the context of interferon's known advantages and disadvantages to address whether interferons should be the first choice for cytoreductive treatment in patients with ET and PV.
干扰素是具有免疫调节特性的细胞因子，几十年来一直用于治疗骨髓增生性肿瘤（MPNs）。然而，由于其不良反应谱和给药困难，其广泛应用受到了阻碍。最近，由于聚乙二醇化制剂耐受性改善，干扰素在 MPN 中的应用再次受到关注。目前，真性红细胞增多症（PV）和特发性血小板增多症（ET）的治疗旨在降低血栓并发症的风险，因为没有已知的可改变疾病的批准疗法。然而，最近关于 MPN 中干扰素的数据表明，其具有疾病修饰活性的潜力，包括达到分子缓解和持续的临床反应。这一发展引发了干扰素是否应该作为 ET 和 PV 的首选一线细胞减少剂的问题，并对目前用于启动治疗的标准提出了挑战。我们回顾了评估干扰素在 ET 和 PV 患者中的疗效和耐受性的随机对照试验数据。然后，我们根据干扰素的已知优缺点来考虑这些数据，以确定干扰素是否应该成为 ET 和 PV 患者细胞减少治疗的首选。
