Tom 3, Nr 3-4 (2023)
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Opublikowany online: 2024-02-01
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Wyniki leczenia przewlekłej białaczki szpikowej w trzeciej linii inhibitorami kinaz tyrozynowych drugiej generacji lub ponatynibem
DOI: 10.5603/hemedu.98828
Hematologia - Edukacja 2023;3(3-4):148-154.
Streszczenie
Rokowanie pacjentów z przewlekłą białaczką szpikową poprawiło się radykalnie od czasu wprowadzenia inhibitorów kinaz tyrozynowych (TKI). Jednakże grupa chorych z opornością/nietolerancją dwóch lub większej liczby linii leczenia wciąż stanowi znaczące wyzwanie terapeutyczne. W badaniu PACE ponatynib stosowano u chorych po nieskutecznym leczeniu dwoma TKI, uzyskując 65% całkowitych odpowiedzi cytogenetycznych (CCyR, complete cytogenetic response), 45% większych odpowiedzi molekularnych (MMR, major molecular response) i 78% 5-letniego przeżycia całkowitego, co dowodzi jego skuteczności w tym wskazaniu. Odsetki MMR, CCyR oraz większych odpowiedzi cytogenetycznych uzyskiwanych w leczeniu trzeciej linii za pomocy TKI drugiej generacji u opornych chorych wynosiły odpowiednio 17–24%, 22–26% oraz 33%, a odpowiedzi były krótkotrwałe. Ponatynib jest skuteczniejszy w terapii trzeciej linii w porównaniu z TKI drugiej generacji i powinien być preferowany zwłaszcza u pacjentów z sekwencyjną opornością na dwa TKI.
Słowa kluczowe: przewlekła białaczka szpikowaleczenie trzeciej liniiponatynibinhibitory kinaz tyrozynowych drugiej generacji
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