伊沙佐米治疗多发性骨髓瘤的临床研究  

Clinical study on ixazomib in the treatment of multiple myeloma

作　　者：贺艳娟[1] 张凯旋 邹浪[1] 陈曙平[1] 蒋端凤 胡健 祝焱[1] HE Yanjuan;ZHANG Kaixuan;ZOU Lang;CHEN Shuping;JIANG Duanfeng;HU Jian;ZHU Yan(Department of Hematology,Xiangya Hospital,Central South University,Changsha 410008;Department of Hematology,Affiliated Hospital of Guilin Medical University,Guilin Guangxi 541000,China)

机构地区：[1]中南大学湘雅医院血液科,长沙410008 [2]桂林医学院附属医院血液科,广西桂林541001

出　　处：《中南大学学报（医学版）》2020年第3期322-327,共6页Journal of Central South University ：Medical Science

基　　金：湖南省自然科学基金(2018JJ2651);北京医卫健康公益基金会医学科学研究基金(YWJKJJHKYJJ-B17464)。

摘　　要：目的:评价伊沙佐米治疗多发性骨髓瘤患者的有效性和安全性。方法:43例多发性骨髓瘤患者接受含伊沙佐米方案治疗,复发/难治骨髓瘤(relapsed/refractory mutiple myeloma,RRMM)16例(RRMM组),硼替佐米初始诱导治疗有效而因不良事件(adverse events,AEs)或欲改善疗效而转换治疗组27例(转换治疗组)。治疗方案为伊沙佐米单药、伊沙佐米联合地塞米松、伊沙佐米联合地塞米松及来那度胺或沙利度胺或环磷酰胺等两药或三药方案。评估疗效和安全性。结果:RRMM组总体反应率(overall response rate,ORR)为56.25%,获得非常好的部分缓解(very good partial response,VGPR)的比率为18.75%,有效者多为远期复发患者。转换治疗组ORR为88.89%,与转换前的ORR(81.48%)相比,疗效有进一步提高,其中59.26%的患者获得了进一步的缓解。主要AEs包括血小板减少、白细胞减少、腹泻、乏力、皮疹、关节疼痛等。结论:伊沙佐米对硼替佐米初始诱导治疗有效后的转换治疗者及远期复发者有效;对于硼替佐米治疗后近期复发患者可能无效。AEs可控。Objective: To evaluate the efficacy and safety of ixazomib in the treatment of multiple myeloma.Methods: A total of 43 patients with multiple myeloma were given ixazomib-based chemotherapy,including 16 patients with relapsed/refractory multiple myeloma(RRMM group),27 patients newly diagnosed multiple myeloma with serious adverse events initially treated with bortezomib(conversion treatment group). Single ixazomib or ixazomib-based 2-or 3-medicine regimens combined with dexamethasone and lenalidomide or thalidomide or cyclophosphamide were performed, and then the response and safety were assessed.Results: The overall response rate(ORR) was 56.25%, and the rate of very good partial response(VGPR) was 18.75% in the RRMM group. Most effective patients were those with long-term recurrence. The ORR was 88.89% in the conversion treatment group,which was further improved compared with the ORR of 81.48% before the conversion,among which 59.26% had a further remission. The main adverse events included thrombocytopenia, leucopenia, diarrhea, asthenia, rash, joint pain, etc.Conclusion: Lxazomib is effective in treating the patients with later recurrence and the patients with serious adverse events initially treated with bortezomib. Lxazomib may not be effective in patients with recent relapse after bortezomib treatment. The adverse events are controllable.

关 键 词：伊沙佐米 多发性骨髓瘤 疗效 安全性 

分 类 号：R733.3[医药卫生—肿瘤]