关于停药的相关内容

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。
! m& z. b0 W% x! M: Y' I! |    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。
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# F2 k; T7 o% F3 y7 M" L1 z作者：来自澳大利亚
来源：Haematologica. 2011.8.9.
Dear Group,
& ~& w# |7 q; _/ B! g" l
3 ]. k; b' D  }. o8 [Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
therapies. Here is a report from Australia on 3 patients who went off Sprycel
9 o/ j0 r9 B7 ^  H7 Y, Bafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
) q: d( W7 B4 ~1 n& c+ n2 @remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
6 X) T# i  G& a; idoes spike up the immune system so I hope more reports come out on this issue.
. s( J3 \; E  T, F8 Q) U
8 n% s3 y) x  K* c. a& R4 D4 h% GThe remarkable news about Sprycel cessation is that all 3 patients had failed
/ e4 a1 u7 J+ b- L+ f. Q/ pGleevec and Sprycel was their second TKI so they had resistant disease. This is
/ V# \& b. Z- R8 udifferent from the stopping Gleevec trial in France which only targets patients
0 m7 n: z, J1 S2 d6 l+ mwho have done well on Gleevec.
9 d* A6 i7 k" v. v) H; e; m  v
Hopefully, the doctors will report on a larger study and long-term to see if the
8 L0 g1 G3 u. F( q7 Vresponse off Sprycel is sustained.
! F: P2 A' }# v# _- ~! ~
Best Wishes,
" z: D6 j1 w) O! tAnjana



Haematologica. 2011 Aug 9. [Epub ahead of print]
Durable complete molecular remission of chronic myeloid leukemia following
dasatinib cessation, despite adverse disease features.
0 s/ k* U  C1 BRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
5 C: P1 U$ z! H+ [Source
4 B  Q9 Z% X8 [. S% bAdelaide, Australia;
0 p3 t# J% ], R
  F; X6 Q: {6 B3 C& o( SAbstract
/ V' B9 D% F! d% i3 K7 o( wPatients with chronic myeloid leukemia, treated with imatinib, who have a
4 n9 ~( [! P$ k: Z2 ~durable complete molecular response might remain in CMR after stopping
) P  o- z$ A0 t- f3 x: @- atreatment. Previous reports of patients stopping treatment in complete molecular
' X# q1 h2 W, X: t$ A' d) Sresponse have included only patients with a good response to imatinib. We
# s/ Y! u+ a/ n" Y! i5 idescribe three patients with stable complete molecular response on dasatinib
7 b: b, N) @! Vtreatment following imatinib failure. Two of the three patients remain in
complete molecular response more than 12 months after stopping dasatinib. In
9 i& Y  W5 Z, }6 N* |these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
  o7 e/ S' d9 S* q1 d$ Y0 [show that the leukemic clone remains detectable, as we have previously shown in
6 |& r, {7 _; m6 _' x% j- limatinib-treated patients. Dasatinib-associated immunological phenomena, such as
. R" D& s& x# p% m) ]/ Fthe emergence of clonal T cell populations, were observed both in one patient
* ~7 D" i' T4 {: F5 [. y7 {2 }  v) Owho relapsed and in one patient in remission. Our results suggest that the
characteristics of complete molecular response on dasatinib treatment may be
% e2 E4 r1 A' Q  T2 e6 Qsimilar to that achieved with imatinib, at least in patients with adverse
% F" p( x$ m- j8 _& b* t5 {8 `disease features.

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。
    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。
    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。

作者：来自法国STIM试验
5 {( H) R  z# `% |& H& I来源：EHA 2011.6.会议摘要

很不错的文章，看来马老师家有考虑停药的想法了啊！祝福！

期盼易或特也能停药，但现在觉得是一个梦想！

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