Abdullah AlZahrani, Nada Alsuhebany, Imran K Tailor, Abdullah M Alrajhi
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引用次数: 0
摘要
Venetoclax 是一种抗凋亡蛋白 B 细胞淋巴瘤 2(BCL2)的选择性抑制剂,是多发性骨髓瘤(MM)患者的靶向治疗药物。美国食品和药物管理局最初于2016年4月批准该药用于治疗慢性淋巴细胞白血病,随后于2020年10月批准该药用于治疗急性髓性白血病。然而,venetoclax作为一种标签外药物,被用于存在t(11;14)易位的复发性和难治性多发性骨髓瘤(RRMM)亚组患者。临床前和临床研究强调了 Venetoclax 在治疗 MM 患者方面的潜力,并特别关注 t(11;14)作为启动基于 Venetoclax 治疗的预测性生物标志物的作用。后来,几项针对 RRMM 患者的研究显示,venetoclax 与地塞米松或/和蛋白酶体抑制剂联合使用可取得良好疗效,管理指南已将 venetoclax 作为治疗 MM 患者的备选方案之一。因此,本综述重点探讨了venetoclax在RRMM中的应用、临床疗效、安全性、剂量策略以及启动venetoclax的预测性生物标志物。此外,我们还讨论了正在进行的研究,这些研究正在对 MM 患者进行不同的 venetoclax 方案组合研究。
Advancing the understanding of venetoclax in t(11;14)-positive multiple myeloma: a comprehensive review of clinical evidence and future prospects.
Venetoclax is a selective inhibitor of the anti-apoptotic protein B-cell lymphoma 2 (BCL2), as a targeted therapy for multiple myeloma (MM) patients. It was initially approved by the United States Food and Drug Administration for the treatment of chronic lymphocytic leukemia in April 2016 and later for acute myeloid leukemia in October 2020. However, venetoclax is used as an off-label in a subset group of relapsed and refractory multiple myeloma (RRMM) patients with the presence of translocation t(11;14). Preclinical and clinical studies have highlighted the potential of venetoclax in the management of MM patients, with a specific focus on t(11;14) as a predictive biomarker for initiating venetoclax-based treatment. Later, several studies in RRMM patients that used venetoclax in combination with dexamethasone or/and proteasome inhibitors have shown promising results, in which management guidelines have included venetoclax as one of the options to treat MM patients. Hence, this review focuses on the use of venetoclax in RRMM, clinical efficacy, safety, dosing strategies, and predictive biomarkers for initiating venetoclax. Additionally, we discuss ongoing studies that are investigating different combination of venetoclax regimens in MM patients.
期刊介绍:
Hematology is an international journal publishing original and review articles in the field of general hematology, including oncology, pathology, biology, clinical research and epidemiology. Of the fixed sections, annotations are accepted on any general or scientific field: technical annotations covering current laboratory practice in general hematology, blood transfusion and clinical trials, and current clinical practice reviews the consensus driven areas of care and management.