Pirtobrutinib复发或难治性b细胞恶性肿瘤(熊):1/2期研究。

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Pirtobrutinib复发或难治性b细胞恶性肿瘤(熊):1/2期研究。

柳叶刀》。2021年3月6日,397 (10277):892 - 901。doi: 10.1016 / s0140 - 6736 (21) 00224 - 5。

PubMed ID
33676628 (在PubMed
]
文摘

背景:共价布鲁顿的酪氨酸激酶(对)杀人案抑制剂在多个b细胞恶性肿瘤是有效的,但是病人停止这些代理由于阻力和不宽容。我们评估的安全性和有效性pirtobrutinib(工作名称;原名loxo - 305),一个高度选择性,可逆对抑制剂杀人案,在这些病人。方法:以前治疗b细胞恶性肿瘤患者参加first-in-human,多中心、非盲、1/2期试验对抑制剂pirtobrutinib杀人案。主要终点是最大耐受剂量(第一阶段)和总体反应率(奥尔;阶段2)。这个试验注册与ClinicalTrials.gov NCT03740529。结果:323名患者接受pirtobrutinib七剂量水平(25毫克,50毫克,100毫克,150毫克,200毫克,250毫克和300毫克每天一次)与线性dose-proportional曝光。没有观察到dose-limiting毒性和最大耐受剂量没有达到。推荐的第二阶段的剂量是每天200毫克。不良事件在323年至少有10%的患者疲劳(65[20%]),腹泻(55[17%]),挫伤(42 [13%])。 The most common adverse event of grade 3 or higher was neutropenia (32 [10%]). There was no correlation between pirtobrutinib exposure and the frequency of grade 3 treatment-related adverse events. Grade 3 atrial fibrillation or flutter was not observed, and grade 3 haemorrhage was observed in one patient in the setting of mechanical trauma. Five (1%) patients discontinued treatment due to a treatment-related adverse event. In 121 efficacy evaluable patients with chronic lymphocytic leukaemia (CLL) or small lymphocytic lymphoma (SLL) treated with a previous covalent BTK inhibitor (median previous lines of treatment 4), the ORR with pirtobrutinib was 62% (95% CI 53-71). The ORR was similar in CLL patients with previous covalent BTK inhibitor resistance (53 [67%] of 79), covalent BTK inhibitor intolerance (22 [52%] of 42), BTK C481-mutant (17 [71%] of 24) and BTK wild-type (43 [66%] of 65) disease. In 52 efficacy evaluable patients with mantle cell lymphoma (MCL) previously treated with covalent BTK inhibitors, the ORR was 52% (95% CI 38-66). Of 117 patients with CLL, SLL, or MCL who responded, all but eight remain progression-free to date. INTERPRETATION: Pirtobrutinib was safe and active in multiple B-cell malignancies, including patients previously treated with covalent BTK inhibitors. Pirtobrutinib might address a growing unmet need for alternative therapies for these patients. FUNDING: Loxo Oncology.

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药物
药物靶点
药物 目标 类 生物 药理作用 行动
Pirtobrutinib 酪氨酸受体激酶BTK 蛋白质 人类
是的
抑制剂
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