关于停药的相关内容

摘要：这3名患者在取得稳定的分子学缓解之后（融合基因转阴PCRU）停用达沙替尼。1名患者复发，另外两名患者在1年后仍保持了PCRU。以前说过，达沙替尼确实可以提高免疫力，希望今后能获得更多的相关研究报告。
    关于这个研究值得注意的是，这三名患者都是服用格列卫失败后转用达沙替尼的，也即他们对格列卫是耐药的。这与法国的格列卫停药研究又有所不同，那个研究中的患者都是对格列卫反应良好的。希望医生们能扩大研究长期观察，看看停用达沙替尼是否能持久不复发。

作者：来自澳大利亚
来源：Haematologica. 2011.8.9.
Dear Group,

; {  U) t+ w' X% d& hSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
9 E: P# ?$ r. u% ]. qtherapies. Here is a report from Australia on 3 patients who went off Sprycel
0 M, h1 A7 C# k  N% L+ @2 k8 l5 Gafter stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
" Q1 w9 p. [  V& d  }) z9 b0 Idoes spike up the immune system so I hope more reports come out on this issue.
" V6 I# x0 a0 |/ H  i, S
) [$ M7 A9 _+ ~; L' {The remarkable news about Sprycel cessation is that all 3 patients had failed
Gleevec and Sprycel was their second TKI so they had resistant disease. This is
different from the stopping Gleevec trial in France which only targets patients
. a" k( {) b( `) J: e+ O) Vwho have done well on Gleevec.

3 ?2 d6 x; H# l* T3 U& u) C# ]Hopefully, the doctors will report on a larger study and long-term to see if the
' B7 B* o8 H* \5 Yresponse off Sprycel is sustained.

Best Wishes,
Anjana
2 B5 X& X" o: Z1 T3 g

1 `, [" A" f3 R2 |/ N, Q
Haematologica. 2011 Aug 9. [Epub ahead of print]
2 f% B' D( L+ x) p  |3 i# KDurable complete molecular remission of chronic myeloid leukemia following
/ c3 [2 v# p5 I& Q  s. l9 pdasatinib cessation, despite adverse disease features.
6 R( v  `' P6 P1 \7 n! Z  ]; j2 |# i0 SRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
* d+ d1 Z9 E* GSource
9 N' h  V9 k: B: ~4 }Adelaide, Australia;
- B  Y7 V1 d5 @7 W  Q/ P9 A/ e
) V& n. w3 l: P9 m+ B( J5 KAbstract
5 x# Y1 Z) H5 ~Patients with chronic myeloid leukemia, treated with imatinib, who have a
+ @8 B, ^  l5 E, b9 bdurable complete molecular response might remain in CMR after stopping
9 `; j: [, U; m# V) F8 xtreatment. Previous reports of patients stopping treatment in complete molecular
6 g% Y1 y0 y; K5 x3 [) Q4 @0 s' Tresponse have included only patients with a good response to imatinib. We
9 }. l7 T' D& ~. c& a4 V4 sdescribe three patients with stable complete molecular response on dasatinib
treatment following imatinib failure. Two of the three patients remain in
$ I9 r4 Y% K8 R6 Tcomplete molecular response more than 12 months after stopping dasatinib. In
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
show that the leukemic clone remains detectable, as we have previously shown in
imatinib-treated patients. Dasatinib-associated immunological phenomena, such as
8 F& r; e9 }8 _! E  kthe emergence of clonal T cell populations, were observed both in one patient
$ ]% P. p. x6 [0 o* ywho relapsed and in one patient in remission. Our results suggest that the
characteristics of complete molecular response on dasatinib treatment may be
. o" ~6 g  U( [( s# r" Qsimilar to that achieved with imatinib, at least in patients with adverse
# i0 L5 J1 v1 Tdisease features.

摘要：（STIM试验为法国的格列卫停药试验。）这个研究中，患者先是取得了CMR（融合基因转阴），然后停用格列卫，而后复发。15名复发患者在重新服药后又一次取得了CMR，他们同意再次停药。
3 v+ `7 K! R6 Y' d3 ]    第一次CMR持续时间为31个月，然后患者停药，复发的中位时间为2.6个月，然后重新服用格列卫，中位时间5.3个月之后取得第二次CMR。保持第二次CMR中位时间19个月之后，患者同意再次停药，这次，15名患者中有5名在停药随访中位时间24个月后仍然保持了CMR，而10名患者在停药中位时间2月后第二次复发。
  Y( f. Q! W' y2 G# ]# _' j' W/ F    请注意，这些患者都是在第一次CMR后停药然后又复发的患者。
/ `3 N6 n  v) S5 S
作者：来自法国STIM试验
- h/ J3 u# Q4 s来源：EHA 2011.6.会议摘要

很不错的文章，看来马老师家有考虑停药的想法了啊！祝福！

期盼易或特也能停药，但现在觉得是一个梦想！

这个非常有意义的研究。能吃下来停会再吃，再停，那是天大的好事