维奈克拉在急性淋巴细胞白血病中的应用和研究进展  

Application and research progress of venetoclax in acute lymphoblastic leukemia

作　　者：孙浩(综述) 李菲(审校)[1] Hao Sun;Fei Li(Department of Hematology,The First Affiliated Hospital of Nanchang University,Jiangxi Clinical Research Center for Hematologic Disease,Jiangxi Provincial Key Laboratory of Hematological Diseases,Nanchang 330006,China)

机构地区：[1]南昌大学第一附属医院血液科,江西省血液病临床医学研究中心,江西省血液系统疾病重点实验室,南昌市330006

出　　处：《中国肿瘤临床》2024年第16期847-851,共5页Chinese Journal of Clinical Oncology

基　　金：江西省科技创新基地计划-江西省血液病临床医学研究中心项目(编号:20212BCG74001);江西省血液系统疾病重点实验室项目(编号:2024SSY06051);江西省主要学科学术和技术带头人培养项目(编号:20213BCJ22016)资助。

摘　　要：维奈克拉是全球首个获批的高选择性口服B细胞淋巴瘤-2(B-cell lymphoma 2,Bcl-2)蛋白抑制剂,具有高亲和性的靶向肿瘤细胞凋亡的独特作用机制,目前已被美国食品药品监督管理局批准应用于治疗慢性淋巴细胞白血病(chronic lymphocytic leukemia,CLL)/小淋巴细胞白血病(small lymphocytic leukemia,SLL)以及不适合接受强诱导化疗或年龄>75岁的新诊断急性髓系白血病(acute myeloid leukemia,AML)。近年来,维奈克拉在治疗急性淋巴细胞白血病(acute lymphoblastic leukemia,ALL)上也显示出其独特的优越性。对于常规治疗方案疗效不佳的特殊亚型ALL,如急性早期前体T淋巴细胞白血病(early T-cell precursor acute lymphoblastic leukemia,ETP-ALL)和ETP-ALL之外的其他复发难治性ALL(relapse/refractory ALL,R/R ALL)经维奈克拉联合化疗或其他靶向药物相较于传统疗法可获得更高的完全缓解(complete response,CR)率和长期生存率,且在费城染色体阳性的ALL(Philadelphia-chromosome positive acute lymphoblastic leukemia,Ph^(+)ALL)中联合酪氨酸激酶抑制剂(tyrosine kinase inhibitor,TKI)也取得了良好的效果,表明维奈克拉在ALL治疗上具有较大前景。本文就维奈克拉在ALL治疗领域的作用及研究进展展开综述。Venetoclax is the first highly selective inhibitor of oral B-cell lymphoma 2(Bcl-2)to be approved.It is characterized by its unique function of targeting the apoptotic pathway of tumor cells with high affinity.Venetoclax has received approval from the U.S.Food and Drug Administration for the treatment of patients with chronic lymphocytic leukemia(CLL)/small lymphocytic leukemia(SLL)and newly diagnosed acute myeloid leukemia(AML)who are not suitable for aggressive induction chemotherapy or those aged>75 years.In recent years,venetoclax has shown superiority in the treatment of acute lymphoblastic leukemia(ALL).Patients with special subtypes of ALL,such as early T-cell precursor ALL(ETP-ALL)and other relapsed/refractory forms of ALL(R/R ALL),who do not respond well to conventional chemotherapy regimens can achieve increased rates of complete response(CR)and long-term survival on receiving venetoclax combined with chemotherapy or other targeted therapies.In addition,the combined use of venetoclax and tyrosine kinase inhibitors(TKI)has demonstrated favorable outcomes in patients with Philadelphia-chromosome positive ALL(Ph+ALL),suggesting the great potential of venetoclax in the treatment of ALL.In this review,we summarized the role of venetoclax in the treatment of ALL and research progress in this field.

关 键 词：维奈克拉 急性淋巴细胞白血病 急性早期前体T淋巴细胞白血病 费城染色体阳性急性淋巴细胞白血病 

分 类 号：R733.71[医药卫生—肿瘤]