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。
; V* r. A  z. o+ H! Q& c  T$ B9 T    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
2 f) e' h6 {5 @4 f6 C' ~& d0 r来源：Haematologica. 2011.8.9.
Dear Group,

/ o0 n5 R) |) d  W; ?8 [  @3 N* NSome of you are on Dasatinib (Sprycel) and we wish to give news on all CML
therapies. Here is a report from Australia on 3 patients who went off Sprycel
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients
3 ^  A" V# z& n, ?; z& Sremain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
) O2 ~2 p* A2 H  Z, x0 M$ ?8 G7 L' wdoes spike up the immune system so I hope more reports come out on this issue.
3 S' T% _+ |7 L& e- {
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
' L, z2 R. R5 o& b5 I6 \different from the stopping Gleevec trial in France which only targets patients
7 _2 c7 {, x3 o) ^5 vwho have done well on Gleevec.
3 ]" `1 a! n% q7 }
/ u3 {4 l$ Q7 {' k6 tHopefully, the doctors will report on a larger study and long-term to see if the
. R$ }  }3 N2 \7 ^0 J1 s3 yresponse off Sprycel is sustained.

Best Wishes,
5 x$ t$ U2 S2 @4 wAnjana


' D) t, {! V* s0 n/ Q% q# T
Haematologica. 2011 Aug 9. [Epub ahead of print]
Durable complete molecular remission of chronic myeloid leukemia following
. X9 r2 e1 \4 t$ S: P& g3 G7 Udasatinib cessation, despite adverse disease features.
Ross DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
2 h2 ~; D& p0 ?( `# `6 y6 PSource
% R+ d: M( r$ HAdelaide, Australia;

Abstract
Patients with chronic myeloid leukemia, treated with imatinib, who have a
% a# f3 A- v7 z6 n. {4 udurable complete molecular response might remain in CMR after stopping
7 o% J- {% C7 d6 j1 @treatment. Previous reports of patients stopping treatment in complete molecular
response have included only patients with a good response to imatinib. We
, @3 c' M; ?& x% Ndescribe three patients with stable complete molecular response on dasatinib
* P0 \$ L7 y! ^7 u6 S8 d% w1 Htreatment following imatinib failure. Two of the three patients remain in
complete molecular response more than 12 months after stopping dasatinib. In
these two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to
# A) }5 r/ B* Y! G8 l; x; Nshow that the leukemic clone remains detectable, as we have previously shown in
8 u7 V8 I8 N+ Z% eimatinib-treated patients. Dasatinib-associated immunological phenomena, such as
1 \: \; Q( s$ ^the emergence of clonal T cell populations, were observed both in one patient
( w3 d5 n/ s4 X7 N. dwho relapsed and in one patient in remission. Our results suggest that the
# u3 h$ V5 C* f% M, Icharacteristics of complete molecular response on dasatinib treatment may be
similar to that achieved with imatinib, at least in patients with adverse
disease 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。
    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。
% V+ f/ w3 u& G7 Z( v+ S, x5 l( M: j    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。
1 ^$ ~2 a6 J5 R
% }3 r2 [4 V- {6 F, ^6 G- O作者：来自法国STIM试验
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