帕纳替尼
医学
达沙替尼
倾向得分匹配
内科学
长春新碱
肿瘤科
微小残留病
费城染色体
环磷酰胺
化疗
白血病
髓系白血病
染色体易位
伊马替尼
化学
基因
生物化学
作者
Koji Sasaki,Elias Jabbour,Farhad Ravandi,Nicholas J. Short,Deborah A. Thomas,Guillermo Garcia‐Manero,Naval Daver,Tapan M. Kadia,Marina Konopleva,Nitin Jain,Ghayas C. Issa,Vicki Jeanis,Haim G. Moore,Rebecca Garris,Naveen Pemmaraju,Jorge E. Cortés,Susan O’Brien,Hagop M. Kantarjian
出处
期刊:Cancer
[Wiley]
日期:2016-08-01
卷期号:122 (23): 3650-3656
被引量:165
摘要
BACKGROUND The clinical efficacy of hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone (HCVAD) plus ponatinib has not been compared with that of HCVAD plus dasatinib in patients with Philadelphia chromosome‐positive acute lymphoblastic leukemia (Ph+ ALL) in a randomized clinical trial. METHODS The authors analyzed 110 patients with newly diagnosed Ph+ ALL who were enrolled in 2 consecutive, prospective, phase 2 clinical trials of frontline HCVAD with either dasatinib (63 patients) or ponatinib (47 patients). Propensity score analysis with 1:1 matching with the nearest neighbor matching method and inverse probability of treatment weighting (IPTW) analysis based on the propensity scores were performed to assess response rates, event‐free survival (EFS), and overall survival (OS) between the cohorts. RESULTS Propensity score matching identified 41 patients in each cohort. With propensity score matching, the 3‐year EFS rates for patients treated with HCVAD plus ponatinib and HCVAD plus dasatinib were 69% and 46%, respectively ( P =.04), and the 3‐year OS rates were 83% and 56%, respectively ( P =.03). IPTW analysis using prematching cohorts demonstrated that patients treated with HCVAD plus ponatinib had significantly higher rates of minimal residual disease negativity by flow cytometry on day 21, complete cytogenetic response at complete response, major molecular response at complete response and at 3 months, and complete molecular response at 3 months. IPTW confirmed that treatment with HCVAD plus ponatinib was associated with longer EFS ( P =.003) and OS ( P =.001) compared with treatment with HCVAD plus dasatinib. CONCLUSIONS The clinical outcome of patients treated with HCVAD plus ponatinib appears to be superior to that of patients treated with HCVAD plus dasatinib among individuals with Ph+ ALL. Cancer 2016;122:3650‐6. © 2016 American Cancer Society .
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