Waldenström's Macroglobulinemia

  • 文章类型: Journal Article
    本文简要总结了iNNOVATE试验的5年结果。原始论文于2021年10月发表在《临床肿瘤学杂志》上。Waldenström巨球蛋白血症(WM)患者随机分为两组,每组75人。一组接受由两种药物组成的联合治疗,伊布替尼加利妥昔单抗,另一组服用安慰剂(“糖丸”)加利妥昔单抗。Ibrutinib(也称为Imbruvica®)是一种降低癌细胞繁殖和生存能力的药物。Ibrutinib是FDA批准的用于治疗WM的药物。利妥昔单抗是一种帮助免疫系统发现和杀死癌细胞的药物。该试验的参与者接受了治疗,他们的健康状况监测长达5年(63个月)。
    在监测的5年中,与服用安慰剂加利妥昔单抗的人相比,服用依鲁替尼加利妥昔单抗的人病情改善,且寿命延长,病情没有恶化.依鲁替尼和利妥昔单抗的副作用是可控的,并且随着时间的推移通常会减少。两个研究组的参与者都报告了生活质量的改善,但与服用安慰剂+利妥昔单抗的患者相比,服用依鲁替尼+利妥昔单抗的患者的生活质量显著改善(通过FACT-An评分衡量).
    这些结果表明,在WM患者中,依鲁替尼联合利妥昔单抗优于单用利妥昔单抗,并且依鲁替尼联合利妥昔单抗长期安全有效。该信息证实了依鲁替尼联合利妥昔单抗作为WM护理标准的作用。临床试验注册:NCT02165397(ClinicalTrials.gov)。
    UNASSIGNED: This article provides a short summary of 5-year results from the iNNOVATE trial. The original paper was published in the Journal of Clinical Oncology in October 2021. People with Waldenström\'s macroglobulinemia (WM) were randomly divided into two groups of 75 people each. One group received a combination treatment composed of two drugs, ibrutinib plus rituximab, and the other group took placebo (\"sugar pill\") plus rituximab. Ibrutinib (also known by the brand name Imbruvica®) is a drug that reduces cancer cells\' ability to multiply and survive. Ibrutinib is an FDA-approved drug for the treatment of WM. Rituximab is a drug that helps the immune system find and kill cancer cells. Participants in the trial were treated and their health monitored for up to 5 years (63 months).
    UNASSIGNED: During the 5 years of monitoring, more people who took ibrutinib plus rituximab experienced an improvement in their disease and lived longer without their disease getting worse compared to those who took placebo plus rituximab. Side effects from ibrutinib and rituximab were manageable and generally decreased over time. Participants in both study groups reported improvements in quality of life, but those who took ibrutinib plus rituximab reported significantly greater improvement in their quality of life (as measured by FACT-An score) compared to those who took placebo plus rituximab.
    UNASSIGNED: These results show that ibrutinib plus rituximab is better than rituximab alone in people with WM and that ibrutinib plus rituximab is safe and effective in the long term. This information confirms the role of ibrutinib plus rituximab as a standard of care for WM. Clinical Trial Registration: NCT02165397 (ClinicalTrials.gov).
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  • 文章类型: Journal Article
    未经授权:奥列拉布替尼是一种小说,小分子,选择性不可逆布鲁顿酪氨酸激酶抑制剂。本研究的目的是评估奥列拉布替尼治疗复发性或难治性Waldenström巨球蛋白血症(R/RWM)患者的疗效和安全性。
    未经批准:这是一个潜在的,奥列拉布替尼在至少接受过一次先前治疗的WM患者中的多中心研究。奥列拉布替尼以150mg的日剂量口服给药直至疾病进展或不可接受的毒性。主要终点是独立审查委员会(IRC)根据IWWM-6评估的主要反应率(MRR)。这项研究在ClinicalTrials.gov注册,NCT04440059。该试验也在药物评价中心注册(www.chinadrugtrials.org.cn)2019年3月,与CTR2019036号。
    未经评估:在2019年8月至2020年12月之间,对66名R/RWM患者进行了资格评估。在中位随访16.4个月(四分位距:12.5,19.5)时,对47名符合条件的患者进行了疗效评估。根据IRC的评估,MRR为80.9%,总有效率为89.4%。达到至少轻微反应的中位时间为1.9个月。12个月PFS率为89.4%。对于MYD88L265P/CXCR4NEG患者,MYD88L265P/CXCR4S338X,和MYD88NEG/CXCR4NEG突变,MRR为84.6%,100%,和25.0%。大多数不良事件为1级或2级(91.0%)。常见的3级或更高的不良事件发生为中性粒细胞减少症(10.6%),血小板减少症(6.4%),和肺炎(4.3%)。严重不良事件(SAE)有10例(21.3%)。报告了一例与治疗相关的死亡(乙型肝炎再激活)。
    UNASSIGNED:奥列拉布替尼在R/RWM患者中显示出良好的疗效和可控制的安全性。
    未经批准:InnoCarePharma。
    UNASSIGNED: Orelabrutinib is a novel, small molecule, selective irreversible Bruton tyrosine kinase inhibitor. The purpose of this study was to evaluate the efficacy and safety of orelabrutinib in patients with relapsed or refractory Waldenström\'s macroglobulinemia (R/R WM).
    UNASSIGNED: This is a prospective, multicenter study of orelabrutinib in patients with WM who had at least one prior line of treatment. Orelabrutinib was administered orally at a daily dose of 150 mg until disease progression or unacceptable toxicity. The primary endpoint was major response rate (MRR) assessed by the Independent Review Committee (IRC) according to IWWM-6. This study is registered with ClinicalTrials.gov, NCT04440059. This trial was also registered on Center for Drug Evaluation (www.chinadrugtrials.org.cn) in March 2019, with a number of CTR2019036.
    UNASSIGNED: Between August 2019 and December 2020, 66 R/R WM patients were assessed for eligibility. Forty-seven eligible patients were evaluated for efficacy at a median follow-up of 16.4 months (interquartile range: 12.5, 19.5). As assessed by IRC, the MRR was 80.9%, and the overall response rate was 89.4%. The median time to at least a minor response was 1.9 months. The PFS rates was 89.4% at 12 months. For patients with MYD88L265P /CXCR4NEG, MYD88L265P /CXCR4 S338X, and MYD88NEG /CXCR4NEG mutations, the MRRs were 84.6%, 100%, and 25.0%. Most adverse events were Grades 1 or 2 (91.0%). The common grade 3 or higher adverse events occurring were neutropenia (10.6%), thrombocytopenia (6.4%), and pneumonia (4.3%). Serious adverse events (SAE) occurred in 10 patients (21.3%). One treatment-related death was reported (hepatitis B reactivation).
    UNASSIGNED: Orelabrutinib has shown good efficacy and manageable safety profiles in patients with R/R WM.
    UNASSIGNED: InnoCare Pharma.
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  • 文章类型: Journal Article
    Waldenstrom\'s macroglobulinemia (WM) is considered by the Revised European American Lymphoma (REAL) and World Health Organization (WHO) as a clinical lympho plasmacytic syndrome associated with high monoclonal (IgM) secretion. The hyper viscosity syndrome is associated with several clinical disorders of monoclonal IgM. Patients with clinical symptoms of hyper viscosity should be treated with plasma pheresis, which is limited by its non-selective removal of all plasma components. These limitations have steered efforts to find a more specific removal according to clinical needs and avoiding plasma components replacement. Removal by specific adsorption is the most powerful selective apheresis technique. The active adsorbed ligand is covalently bound to an insoluble matrix through which plasma is passed. Amino acids have been introduced as ligands in clinical apheresis for the removal of auto antibodies associated with autoimmune diseases. The present preliminary study describes the binding of monoclonal IgM antibodies from sera of patients with WM, on histidine immobilized to activated sepharose. The advantages of efficient binding and elution, suggest histidine adsorbents as prospective clinical means suitable for the removal of monoclonal IgM from sera of patients diagnosed with WM. The advantages of efficient adsorption and elution, non toxicity of histidine, good selectivity, good stability, as well as their low cost strongly suggest histidine adsorbents as prospective clinical means suitable for the removal of monoclonal IgM from sera of patients diagnosed with WM.
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