4.The efficacy and safety of Bruton tyrosine kinase inhibitors as monotherapy in the treatment of newly diagnosed patients with Waldenström macroglobulinemia.
Yi TAO ; Yun Lu XU ; Shuo WANG ; Li WANG ; Wei Li ZHAO
Chinese Journal of Hematology 2023;44(6):490-494
Objective: To investigate the efficacy and safety of Bruton tyrosine kinase inhibitors (BTKi) ibrutinib or zanubrutinib monotherapy in newly diagnosed patients with Waldenström macroglobulinemia (WM) . Methods: The efficacy and adverse effects of 58 patients with newly diagnosed WM receiving BTKi monotherapy in Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine were analyzed retrospectively from January 2018 to August 2022. Results: The response of 55 patients may be examined. Forty patients received ibrutinib monotherapy for a median of 15 months, with an overall response rate (ORR) of 85%, a main remission rate (MRR) of 70%, and a very good partial remission (VGPR) rate of 10%. Fifteen patients received zanubrutinib monotherapy for a median of 13 months, with an ORR of 93%, an MRR of 73%, and a VGPR rate of 0%. For various reasons, 10 patients were converted from ibrutinib to zanubrutinib. Ibrutinib treatment lasted an average of 7.5 months before conversion. The median duration of zanubrutinib therapy after conversion was 3.5 months. The ORRs before and after conversion were 90% and 100%, MRRs were 80% and 80%, and VGPR rates were 10% and 50%, respectively. After a median of 16 months, the 24-month progression-free survival (PFS) rate of patients who received both BTKi was 86%. PFS did not differ statistically across individuals with low, medium, and high-risk ISS scores (P=0.998). All of the patients survived. The most common side effects of BTKi were neutropenia and thrombocytopenia, which occurred in 12% and 10% of all patients, respectively. Ibrutinib accounts for 5% of atrial fibrillation, and zanubrutinib has a 7% risk of bleeding. Conclusions: In treating WM, ibrutinib or zanubrutinib provides good efficacy and tolerable adverse effects.
Humans
;
China
;
Retrospective Studies
;
Treatment Outcome
;
Tyrosine Protein Kinase Inhibitors/therapeutic use*
;
Waldenstrom Macroglobulinemia/drug therapy*
5.Research Progress of FLT3 Mutation in Acute Myeloid Leukemia --Review.
Journal of Experimental Hematology 2023;31(3):922-926
Acute myeloid leukemia (AML) is a heterogeneous hematopoietic tumor originated from hematopoietic stem cells. FLT3 is an important receptor tyrosine kinase in cell signal transduction pathway and one of the common mutated genes in AML. AML patients with FLT3-ITD mutation have a poor prognosis and tendency to relapse. Therefore, early identification of FLT3 gene mutation and selection of appropriate treatment are particularly important. Currently, the small moleculetargeted drugs have been new treatment methods for AML patients with FLT3-ITD mutation, but accompanied drug resistance need to be solved. This paper reviews the mechanism of FLT3 mutation, the clinical significance of FLT3 mutation in AML, FLT3 inhibitors and drug resistance mechanism.
Humans
;
Mutation
;
Protein Kinase Inhibitors/therapeutic use*
;
Signal Transduction
;
Receptor Protein-Tyrosine Kinases/therapeutic use*
;
Leukemia, Myeloid, Acute/drug therapy*
;
fms-Like Tyrosine Kinase 3/genetics*
6.Advancesin FLT3 inhibitors for acute myeloid leukemia.
Meng ZHOU ; Xiao Ling CHU ; Sheng Li XUE ; De Pei WU
Chinese Journal of Hematology 2019;40(9):787-791
8.Molecular Basis of Drug Resistance: Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors and Anaplastic Lymphoma Kinase Inhibitors.
Tuberculosis and Respiratory Diseases 2013;75(5):188-198
Over the past decade, several kinase inhibitors have been approved based on their clinical benefit in cancer patients. Unfortunately, in many cases, patients develop resistance to these agents via secondary mutations and alternative mechanisms. To date, several major mechanisms of acquired resistance, such as secondary mutation of the epidermal growth factor receptor (EGFR) gene, amplification of the MET gene and overexpression of hepatocyte growth factor, have been reported. This review describes the recent findings on the mechanisms of primary and acquired resistance to EGFR tyrosine kinase inhibitors and acquired resistance to anaplastic lymphoma kinase inhibitors, primarily focusing on non-small cell lung carcinoma.
Drug Resistance*
;
Epidermal Growth Factor*
;
Hepatocyte Growth Factor
;
Humans
;
Lung
;
Lymphoma*
;
Phosphotransferases*
;
Protein Kinase Inhibitors
;
Protein-Tyrosine Kinases
;
Receptor Protein-Tyrosine Kinases
;
Receptor, Epidermal Growth Factor*
9.Advances in the study of inhibitors of kinases and nuclear factors for treating allergic asthma.
Ren-Ping LIU ; Ai-Min MENG ; Qi HOU
Acta Pharmaceutica Sinica 2012;47(6):689-695
Currently, about 300 million people worldwide are affected by asthma. Most of these sufferers inhale immunosuppressants (ie corticosteroids) and beta-adrenergic receptor agonists for their asthma treatment. However, about 5%-10% of patients of asthma have poor response to such treatment. Investigation of kinase signaling pathway and nuclear transcription factor as a target molecule in the treatment of allergic asthma has been the concern of scholars home and abroad. This paper reviewed inhibitors of kinase signaling pathway and nuclear transcription factors for the treatment of asthma.
Animals
;
Asthma
;
drug therapy
;
enzymology
;
Humans
;
Mitogen-Activated Protein Kinases
;
antagonists & inhibitors
;
Phosphatidylinositol 3-Kinase
;
antagonists & inhibitors
;
Protein Kinase Inhibitors
;
therapeutic use
;
Protein-Tyrosine Kinases
;
antagonists & inhibitors
;
metabolism
;
Signal Transduction
;
Transcription Factors
;
antagonists & inhibitors
10.Research Progress on TKI Resistance of CML Cells Mediated by MSC through CXCL12/CXCR4 Axis.
Li-Jun FANG ; Huai-Jun TU ; Jian LI
Journal of Experimental Hematology 2015;23(4):1221-1224
Although the tyrosinekinase inhibitors (TKI) displayed a significant curative effect on chronic myeloid leukemia (CML), but the drug resistance in treatment course of this disease still can not be avoided. Studies recently have shown that the mesenchymal stem cells (MSC) can induce CML cells to resist TKI therapy by CXCL12/CXCR4 axis from multiple aspects, such as the directional migration of CML cells, adherence to marrow cavity, the mediation of cell protective dormancy, activations of numerous survival signaling pathways, the suppression of mitochondrial-dependent apoptosis and the up-regulated expression of BCL-6. The combination of TKI and CXCR4 antagonists will be a novel treatment strategy to raise the genetic cure rate of CML. In this article, the pathways of drug resistance, pathways of sensitivity to CXCL12 and pathways of CML cell adherence to marrow cavity in CML cells mediated by MSC were reviewed.
Drug Resistance, Neoplasm
;
Humans
;
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
;
Protein Kinase Inhibitors
;
Protein-Tyrosine Kinases
;
Signal Transduction
;
Stem Cells