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2023年急性髓系白血病管理的范式转变——获批的治疗选择

Paradigm Shift in the Management of Acute Myeloid Leukemia-Approved Options in 2023.

作者信息

Premnath Naveen, Madanat Yazan F

机构信息

Division of Hematology and Medical Oncology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75235, USA.

Leukemia Program, Harold C. Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX 75235, USA.

出版信息

Cancers (Basel). 2023 May 31;15(11):3002. doi: 10.3390/cancers15113002.

Abstract

The word Leukemia was coined nearly 200 years ago by Rudolf Virchow. Once a death sentence, Acute Myeloid Leukemia (AML) is now a treatable condition. The introduction of "7 + 3" chemotherapy, originally reported from the Roswell Park Memorial institute in Buffalo, New York, in 1973, changed the treatment paradigm for AML. About twenty-seven years later, FDA approved the first targeted agent, gemtuzumab, to be added to this backbone. During the last seven years, we have had ten new drugs approved for the management of patients with AML. Work by many dedicated scientists led to AML achieving the elite status of being the first cancer to have the whole genome sequenced using next-generation sequencing. In the year 2022, we witnessed the introduction of new classification systems for AML by the international consensus classification and the world health organization, both emphasizing molecular classification of the disease. In addition, the introduction of agents such as venetoclax and targeted therapies have changed the treatment paradigm in older patients ineligible for intensive therapy. In this review, we cover the rationale and evidence behind these regimens and provide insights into the newer agents.

摘要

“白血病”这个词是近200年前由鲁道夫·魏尔啸创造的。急性髓系白血病(AML)曾经是一种绝症,如今已成为可治疗的疾病。1973年,纽约布法罗的罗斯威尔公园纪念研究所首次报道的“7 + 3”化疗方案改变了AML的治疗模式。大约27年后,美国食品药品监督管理局(FDA)批准了第一种靶向药物吉妥珠单抗,并将其加入到这一主要治疗方案中。在过去七年里,我们有十种新药被批准用于治疗AML患者。许多敬业科学家的工作使AML成为首个通过新一代测序完成全基因组测序的癌症,从而获得了卓越地位。2022年,我们见证了国际共识分类和世界卫生组织为AML引入新的分类系统,二者均强调对该疾病进行分子分类。此外,维奈克拉等药物和靶向治疗方法的引入改变了不适合强化治疗的老年患者的治疗模式。在这篇综述中,我们阐述了这些治疗方案背后的基本原理和证据,并对新型药物进行了深入分析。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5963/10251983/823e6fa4b395/cancers-15-03002-g001.jpg

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