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9905 15 老马 发表于 2013-5-14 07:55:26 |
老马  博士一年级 发表于 2013-5-14 08:04:04 | 显示全部楼层 来自: 浙江温州
摘要:这3名患者在取得稳定的分子学缓解之后(融合基因转阴PCRU)停用达沙替尼。1名患者复发,另外两名患者在1年后仍保持了PCRU。以前说过,达沙替尼确实可以提高免疫力,希望今后能获得更多的相关研究报告。
' T+ S' O0 v  |    关于这个研究值得注意的是,这三名患者都是服用格列卫失败后转用达沙替尼的,也即他们对格列卫是耐药的。这与法国的格列卫停药研究又有所不同,那个研究中的患者都是对格列卫反应良好的。希望医生们能扩大研究长期观察,看看停用达沙替尼是否能持久不复发。  F2 z  B& ?* j  X2 T1 ^
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作者:来自澳大利亚
% s& H' Q' T" |5 v8 X来源:Haematologica. 2011.8.9.
, }2 M- J  s5 s9 rDear Group,
* {& S5 K' z6 S+ {* o+ _8 k; J
+ F/ S5 ^+ y+ Y% ~5 J. vSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
; h$ n4 K' I8 x# x3 J% ]/ ptherapies. Here is a report from Australia on 3 patients who went off Sprycel
6 f* f# m. x! c( }; p8 Yafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients! t: L  J6 `, j0 ~- V" x% g
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel) c4 t- v+ Q- o+ u8 b9 y3 I$ C$ {
does spike up the immune system so I hope more reports come out on this issue.
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The remarkable news about Sprycel cessation is that all 3 patients had failed
5 J" h8 l& o: Z* N3 R4 RGleevec and Sprycel was their second TKI so they had resistant disease. This is/ K! H. n! S* v5 i' Z$ B9 b" U
different from the stopping Gleevec trial in France which only targets patients: m5 V& b1 v: ~- M- c% R
who have done well on Gleevec./ _7 E  \% @1 {% ^4 D! C/ }
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Hopefully, the doctors will report on a larger study and long-term to see if the
1 k. J6 _+ ]6 t) Kresponse off Sprycel is sustained.) ^6 Q* }- a5 i) O

0 p2 a6 U' ?2 z$ RBest Wishes,
2 \# V# d& f2 F. {. nAnjana  w+ N& x- A% P. S) X4 i% Z

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1 o. |* v  J" c7 C# }# |Haematologica. 2011 Aug 9. [Epub ahead of print]
6 O) s( x) B/ b7 RDurable complete molecular remission of chronic myeloid leukemia following
$ J  P+ Z9 x0 A0 G# e, \) tdasatinib cessation, despite adverse disease features.
- g# b, p. m8 uRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
# b  j8 G  z2 ]2 a" Y2 {Source8 {9 d5 i8 F, \- _- X1 L, T7 ^
Adelaide, Australia;
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2 s: u9 a) p$ h1 A6 @. UAbstract
" T, \+ z& J+ _$ i9 k( t3 ^Patients with chronic myeloid leukemia, treated with imatinib, who have a6 G; A4 y$ `1 H! D1 M
durable complete molecular response might remain in CMR after stopping- J3 N3 _7 B8 Y0 F
treatment. Previous reports of patients stopping treatment in complete molecular. x: O( `. X$ [  k0 o
response have included only patients with a good response to imatinib. We
/ W8 }. _0 j8 |3 n9 Gdescribe three patients with stable complete molecular response on dasatinib# r2 s9 w1 A8 l/ q
treatment following imatinib failure. Two of the three patients remain in6 D' g' h; v1 x
complete molecular response more than 12 months after stopping dasatinib. In
/ L7 Q( J/ x& z1 Z1 k2 B- Z' ^these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to" E6 q; M( ]" K' q' @
show that the leukemic clone remains detectable, as we have previously shown in) K0 a1 i" L9 g5 W/ M
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
( m) Y# e% V2 k: o% X6 ethe emergence of clonal T cell populations, were observed both in one patient
, O! p" t' g1 i8 p- gwho relapsed and in one patient in remission. Our results suggest that the  ~2 ]4 ]$ M  y9 o; |, y$ l
characteristics of complete molecular response on dasatinib treatment may be, ~; D  k( D$ c6 f9 I2 w1 {$ X
similar to that achieved with imatinib, at least in patients with adverse( v1 x/ T1 B+ V! [0 `2 }
disease features.
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个人公众号:treeofhope

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老马  博士一年级 发表于 2013-5-14 08:04:25 | 显示全部楼层 来自: 浙江温州
摘要:(STIM试验为法国的格列卫停药试验。)这个研究中,患者先是取得了CMR(融合基因转阴),然后停用格列卫,而后复发。15名复发患者在重新服药后又一次取得了CMR,他们同意再次停药。5 q- k5 i& c! |6 |  V; n1 A! ?
    第一次CMR持续时间为31个月,然后患者停药,复发的中位时间为2.6个月,然后重新服用格列卫,中位时间5.3个月之后取得第二次CMR。保持第二次CMR中位时间19个月之后,患者同意再次停药,这次,15名患者中有5名在停药随访中位时间24个月后仍然保持了CMR,而10名患者在停药中位时间2月后第二次复发。/ p% l1 {6 P1 b# X5 c0 W
    请注意,这些患者都是在第一次CMR后停药然后又复发的患者。% w1 w7 ^  Y& K: l5 b

0 F9 G% Z7 [+ f7 A2 I作者:来自法国STIM试验, W& P# N6 J0 d$ w+ Y% }6 h! U" \
来源:EHA 2011.6.会议摘要
个人公众号:treeofhope

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gjzlovemama  初中一年级 发表于 2013-5-14 23:45:09 | 显示全部楼层 来自: 山东滨州
很不错的文章,看来马老师家有考虑停药的想法了啊!祝福!

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jack_7777  禁止访问 发表于 2014-11-22 19:47:19 | 显示全部楼层 来自: 广东广州
提示: 作者被禁止或删除 内容自动屏蔽
签名被屏蔽
sdlclqm  大学一年级 发表于 2015-9-29 19:03:13 | 显示全部楼层 来自: 山东聊城
期盼易或特也能停药,但现在觉得是一个梦想!
monekyll  大学二年级 发表于 2015-10-2 12:44:50 | 显示全部楼层 来自: 广东
这个非常有意义的研究。能吃下来停会再吃,再停,那是天大的好事

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