接受伊马替尼一线治疗的慢性髓性白血病慢性期患者应何时换用2代TKI

慢性期慢性髓性白血病患者接受伊马替尼一线治疗后,虽然大部分患者可显著获益,但仍有相当比例的患者不能获得满意疗效。如果患者未获得满意疗效,则依然存在疾病进展风险。因此,对于伊马替尼治疗失败或疗效欠佳的患者,需要考虑转换其他替代治疗,以得到最大获益。研究显示伊马替尼治疗失败的患者换用第2代TKI——尼洛替尼治疗获益显著。本文综述了伊马替尼治疗失败的患者换用尼洛替尼后的疗效并对换用时机进行探讨。

When should first-line imatinib treatment of CML-CP patients switch to second-generation TKI

Though most of CML-CP patients receiving first-line imatinib therapy could get response,there were still quite a few patients not achieving optimal response,which means there are still risks of disease progression for them.Therefore,for patients who fail to respond to imatinib therapy or only have suboptimal response,other alternative treatments should be taken into consideration to maximize the benefit of treatment.There has been data showing that CML patients failing to imatinib could get remarkable response when they switch to 2nd generation TKI.This review summarized the efficacy of nilotinib on CML patients failing or sub-optimally responding to imatinib,and discussed the right time for switch.