{"title":"曾接受⩾2酪氨酸激酶抑制剂治疗的慢性期慢性髓性白血病患者的治疗：系统性文献综述。","authors":"Ehab Atallah, Lovneet Saini, Rodrigo Maegawa, Tanvi Rajput, Regina Corbin, Ricardo Viana","doi":"10.1177/20406207221150305","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>ATP-competitive tyrosine kinase inhibitors (TKIs) are the current standard of care for patients with chronic phase-chronic myeloid leukemia (CP-CML) in the first-line and second-line (2 L) setting. Treatment after 2 L is not clearly established.</p><p><strong>Objective: </strong>The objective of this study was to summarize the available evidence to compare the efficacy and safety of interventions in the treatment of CP-CML patients who had received ⩾2 prior TKIs.</p><p><strong>Design: </strong>A systematic literature review was performed.</p><p><strong>Data source and methods: </strong>A systematic literature review (SLR) of studies published until May 2021, reporting clinical outcomes in adult patients with CP-CML who had received ⩾ 2 prior TKIs was performed. Studies were identified through the database searches via Ovid platform (Embase, MEDLINE Epub Ahead of Print, In-Process and Other Non-Indexed Citations, and Cochrane Central Register of Controlled Trials), the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP), bibliographic search of relevant reviews, and proceedings from the previous 3 years of the key conferences in the field of oncology.</p><p><strong>Results: </strong>Our search identified 38 relevant studies. Among the identified studies of the current third-line treatments, the major molecular response (MMR) rate for ponatinib was 19.0-66.7%, 23.3-25.5% for asciminib, 19.2% for omacetaxine, and 13.2% for bosutinib at 6 months. The complete cytogenetic response (CCyR) rate was 21.4-64.8% for ponatinib, 38.7-40.8% for asciminib, 18-24.2% for bosutinib, and 16.1% for omacetaxine at 6 months.</p><p><strong>Conclusion: </strong>The findings from current SLR demonstrated the lack of data for patients with CML treated with ⩾2 TKIs. TKIs such as asciminib, ponatinib, and bosutinib are valid options for those patients. Further research is needed to identify the best treatment option for patients with CML receiving later lines of therapy.</p>","PeriodicalId":23048,"journal":{"name":"Therapeutic Advances in Hematology","volume":null,"pages":null},"PeriodicalIF":3.4000,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10725100/pdf/","citationCount":"0","resultStr":"{\"title\":\"Therapy for patients with chronic phase-chronic myeloid leukemia previously treated with ⩾2 tyrosine kinase inhibitors: a systematic literature review.\",\"authors\":\"Ehab Atallah, Lovneet Saini, Rodrigo Maegawa, Tanvi Rajput, Regina Corbin, Ricardo Viana\",\"doi\":\"10.1177/20406207221150305\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>ATP-competitive tyrosine kinase inhibitors (TKIs) are the current standard of care for patients with chronic phase-chronic myeloid leukemia (CP-CML) in the first-line and second-line (2 L) setting. Treatment after 2 L is not clearly established.</p><p><strong>Objective: </strong>The objective of this study was to summarize the available evidence to compare the efficacy and safety of interventions in the treatment of CP-CML patients who had received ⩾2 prior TKIs.</p><p><strong>Design: </strong>A systematic literature review was performed.</p><p><strong>Data source and methods: </strong>A systematic literature review (SLR) of studies published until May 2021, reporting clinical outcomes in adult patients with CP-CML who had received ⩾ 2 prior TKIs was performed. Studies were identified through the database searches via Ovid platform (Embase, MEDLINE Epub Ahead of Print, In-Process and Other Non-Indexed Citations, and Cochrane Central Register of Controlled Trials), the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP), bibliographic search of relevant reviews, and proceedings from the previous 3 years of the key conferences in the field of oncology.</p><p><strong>Results: </strong>Our search identified 38 relevant studies. Among the identified studies of the current third-line treatments, the major molecular response (MMR) rate for ponatinib was 19.0-66.7%, 23.3-25.5% for asciminib, 19.2% for omacetaxine, and 13.2% for bosutinib at 6 months. 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引用次数: 0
摘要
背景：ATP竞争性酪氨酸激酶抑制剂（TKIsATP竞争性酪氨酸激酶抑制剂（TKIs）是慢性期慢性髓性白血病（CP-CML）患者一线和二线（2 L）治疗的现行标准。二线治疗后的治疗方法尚未明确确立：本研究的目的是总结现有证据，比较干预措施对既往接受过⩾2 种 TKIs 治疗的 CP-CML 患者的疗效和安全性：数据来源与方法：对截至 2021 年 5 月发表的研究进行了系统性文献综述 (SLR)，这些研究报告了既往接受过⩾2 种 TKIs 治疗的 CP-CML 成年患者的临床结果。研究是通过Ovid平台数据库检索（Embase、MEDLINE Epub Ahead of Print、In-Process and Other Non-Indexed Citations和Cochrane Central Register of Controlled Trials）、世界卫生组织（WHO）国际临床试验注册平台（ICTRP）、相关综述的书目检索以及肿瘤学领域前3年重要会议的论文集确定的：结果：我们的搜索发现了 38 项相关研究。在已确定的当前三线治疗研究中，6个月时的主要分子反应率（MMR）分别为：泊纳替尼 19.0%-66.7%、阿西米尼 23.3%-25.5%、奥美他辛 19.2%、博苏替尼 13.2%。6个月后的完全细胞遗传学应答率（CCyR）为：泊纳替尼21.4%-64.8%，阿西米尼38.7%-40.8%，博舒替尼18%-24.2%，奥美他辛16.1%：目前的SLR研究结果表明，使用⩾2种TKIs治疗的CML患者缺乏数据。阿西替尼、泊纳替尼和博苏替尼等 TKIs 是这些患者的有效选择。还需要进一步研究，以确定接受后续治疗的 CML 患者的最佳治疗方案。
Therapy for patients with chronic phase-chronic myeloid leukemia previously treated with ⩾2 tyrosine kinase inhibitors: a systematic literature review.
Background: ATP-competitive tyrosine kinase inhibitors (TKIs) are the current standard of care for patients with chronic phase-chronic myeloid leukemia (CP-CML) in the first-line and second-line (2 L) setting. Treatment after 2 L is not clearly established.
Objective: The objective of this study was to summarize the available evidence to compare the efficacy and safety of interventions in the treatment of CP-CML patients who had received ⩾2 prior TKIs.
Design: A systematic literature review was performed.
Data source and methods: A systematic literature review (SLR) of studies published until May 2021, reporting clinical outcomes in adult patients with CP-CML who had received ⩾ 2 prior TKIs was performed. Studies were identified through the database searches via Ovid platform (Embase, MEDLINE Epub Ahead of Print, In-Process and Other Non-Indexed Citations, and Cochrane Central Register of Controlled Trials), the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP), bibliographic search of relevant reviews, and proceedings from the previous 3 years of the key conferences in the field of oncology.
Results: Our search identified 38 relevant studies. Among the identified studies of the current third-line treatments, the major molecular response (MMR) rate for ponatinib was 19.0-66.7%, 23.3-25.5% for asciminib, 19.2% for omacetaxine, and 13.2% for bosutinib at 6 months. The complete cytogenetic response (CCyR) rate was 21.4-64.8% for ponatinib, 38.7-40.8% for asciminib, 18-24.2% for bosutinib, and 16.1% for omacetaxine at 6 months.
Conclusion: The findings from current SLR demonstrated the lack of data for patients with CML treated with ⩾2 TKIs. TKIs such as asciminib, ponatinib, and bosutinib are valid options for those patients. Further research is needed to identify the best treatment option for patients with CML receiving later lines of therapy.
期刊介绍：
Therapeutic Advances in Hematology delivers the highest quality peer-reviewed articles, reviews, and scholarly comment on pioneering efforts and innovative studies across all areas of hematology. The journal has a strong clinical and pharmacological focus and is aimed at clinicians and researchers in hematology, providing a forum in print and online for publishing the highest quality articles in this area.
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