三種藥物治療為一種血癌類(lèi)型--多發(fā)性骨髓瘤提供了快速,，深刻的和潛在的持久的反應(yīng),，研究人員將最新研究論文發(fā)表在Blood雜志上,。
芝加哥大學(xué)醫(yī)學(xué)中心的主任醫(yī)師Andrzej J. Jakubowiak博士帶領(lǐng)研究人員發(fā)現(xiàn)相比原于一線治療方案,，carfilzomib（新一代蛋白酶抑制劑）聯(lián)合lenalidomide和低劑量地塞米松治療多發(fā)性骨髓瘤效果更好,。
Jakubowiak說(shuō)：這些迅速和持久的藥物應(yīng)答反應(yīng)明顯優(yōu)于目前治療多發(fā)性骨髓瘤的既定方案,。 參加該研究小組的有四個(gè)臨床中心的53名患者,。患者年齡在35至81歲之間,，都是剛被新診斷為患有多發(fā)性骨髓瘤,。每個(gè)病人給予所有三種藥物，carfilzomib劑量水平被提高兩倍,。這些藥物組合基本能對(duì)多數(shù)病人起到迅速療效,，并療效較持久。Jakubowiak說(shuō)：初診患者骨髓瘤是最敏感的治療對(duì)象,。（生物谷：Bioon.com）
doi:10.1182/blood-2012-04-422683
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A phase 1/2 study of carfilzomib in combination with lenalidomide and low-dose dexamethasone as a frontline treatment for multiple myeloma
Andrzej J. Jakubowiak,*, Dominik Dytfeld, Kent A. Griffith, Daniel Lebovic, David H. Vesole, Sundar Jagannath, Ammar Al-Zoubi, Tara Anderson, et al.
This phase 1/2 study in patients with newly diagnosed multiple myeloma (N=53) assessed CRd—carfilzomib (20, 27, or 36 mg/m2, days 1, 2, 8, 9, 15, 16 and 1, 2, 15, 16 after Cycle 8), lenalidomide (25 mg/day, days 1–21), and weekly dexamethasone (40/20 mg Cycles 1–4/5+)—in 28-day cycles. After Cycle 4, transplant-eligible candidates underwent stem cell collection (SCC) then continued CRd with the option of transplantation. The maximum planned dose level (carfilzomib 36 mg/m2) was expanded in phase 2 (n=36). Thirty-five patients underwent SCC, 7 proceeded to transplantation, and the remainder resumed CRd. Grade 3/4 toxicities included hypophosphatemia (25%), hyperglycemia (23%), anemia (21%), thrombocytopenia (17%), and neutropenia (17%); peripheral neuropathy was limited to Grade 1/2 (23%). Most patients did not require dose modifications. After a median of 12 cycles (range 1–25), 62% (N=53) achieved at least near complete response (nCR) and 42% stringent CR (sCR). Responses were rapid and improved during treatment. In 36 patients completing 8 or more cycles, 78% reached at least nCR and 61% sCR. With median follow-up of 13 months (range 4–25), 24-month progression-free survival estimate was 92%. CRd was well tolerated with exceptional response rates. Registered at www.clinicaltrials.
