摘要
背景:超过85%的受急性淋巴细胞白血病(ALL)影响的儿童成功治疗; 然而复发仍然是一个显着的临床问题,50-60%的复发患者面临致命的结果。复发患者的管理包括基于常规药物的标准化密集型风险适应方案,以及对不利特征的患者的造血干细胞移植。近来,生物药物,特别是单克隆抗体依帕珠珠单抗和双功能重链单链肽蓝细胞瘤已被公认为是将其纳入救助ALL疗法的新型潜在药物,以进一步改善救援结果。 方法:对公共数据库中同行评议的科学文献和临床试验进行系统的检索。临床和临床前研究已经被纳入,以总结近期有关依普珠珠单抗和布林莫单抗的救援ALL疗法的证据。 结果:共纳入文献25篇,临床试验六十篇。虽然并非所有患者对这些药物反应良好,但它们在复发和难治性儿科中的应用似乎都很有前途。 结论:最近开始了3期研究,与传统疗法相比,预期在未来几年内,关于依普珠单抗和平滑肌瘤的安全性和疗效更一致。依帕珠单抗似乎是安全的给药方案,但其疗效是否优于常规化疗仍值得商榷。布林莫单抗已经显示出可喜的成果,在高风险的情况下如老年患者和儿童都还需要确凿的研究。这些药物并没有深入研究患者间的个体差异,但这个问题需要解决,特别是布林莫单抗。
关键词: 急性淋巴细胞白血病,单克隆抗体,依帕珠单抗,布林莫单抗(青霉素),疗效、毒性的分子机制,儿科。
Current Medicinal Chemistry
Title:Epratuzumab and Blinatumomab as Therapeutic Antibodies for Treatment of Pediatric Acute Lymphoblastic Leukemia: Current Status and Future Perspectives
Volume: 24 Issue: 11
关键词: 急性淋巴细胞白血病,单克隆抗体,依帕珠单抗,布林莫单抗(青霉素),疗效、毒性的分子机制,儿科。
摘要: Background: More than 85% of children affected by acute lymphoblastic leukemia (ALL) are successfully treated; however relapse remains a remarkable clinical concern, with 50-60% of relapsing patients facing a fatal outcome. Management of relapsed patients includes standardized intensive risk-adapted regimens based on conventional drugs, and hematopoietic stem cells transplantation for patients with unfavourable features. Biological drugs, in particular the monoclonal antibody epratuzumab and the bi-functional recombinant single chain peptide blinatumomab, have been recently recognized as novel potential agents to be integrated in salvage ALL therapy to further improve rescue outcome.
Methods: A systematic search of peer-reviewed scientific literature and clinical trials in public databases has been carried out. Both clinical and pre-clinical studies have been included to summarize recent evidence on epratuzumab and blinatumomab for salvage ALL therapy. Results: Sixty-two papers and 25 clinical trials were included. Although not all patients responded properly to these agents, their use in relapsed and refractory pediatric ALL seems promising. Conclusion: Phase 3 studies have recently begun and more consistent results about epratuzumab and blinatumomab safety and efficacy in comparison to conventional therapies are expected in the next years. Epratuzumab seems safe in the dosing scheme proposed in ALL, but its efficacy over the conventional chemotherapy is still questionable. Blinatumomab has shown promising results in high risk cases such as elder adult patients and conclusive studies on pediatric ALL are needed. Patient inter-individual variability to these agents has not been investigated in depth, but this issue needs to be addressed, in particular for blinatumomab.Export Options
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Cite this article as:
Epratuzumab and Blinatumomab as Therapeutic Antibodies for Treatment of Pediatric Acute Lymphoblastic Leukemia: Current Status and Future Perspectives, Current Medicinal Chemistry 2017; 24 (11) . https://dx.doi.org/10.2174/0929867324666170113105733
DOI https://dx.doi.org/10.2174/0929867324666170113105733 |
Print ISSN 0929-8673 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-533X |
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