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白血病新药!第一三共 2 代 FLT3 抑制剂 Vanflyta 日本获全球首批,治疗 FLT3-ITD 急性髓性白血病

  第一三共制药(Daiichi Sankyo)近日宣布,日本卫生劳动福利部(MHLW)已批准靶向抗癌药Vanflyta(quizartinib),该药是一种口服FLT3抑制剂,用于治疗复发性/难治性FLT3-ITD急性髓性白血病(AML)成人患者。在美国方面,Vanflyta审查时间在今年4月遭FDA延长3个月,至2019年8月25日。

此次批准,是基于全球性关键III期临床研究QuANTUM-R以及一项在日本复发性/难治性FLT3-ITD AML患者中开展的II期临床研究的数据。

    值得一提的是,QuANTUM-R研究是评估一种FLT3抑制剂作为口服单药疗法相对化疗治疗复发性/难治性FLT3-ITD AML患者显著延长总生存期的首个随机III期研究。在该研究中,与挽救性化疗相比,Vanflyta口服单药疗法使死亡风险显著降低24%(HR=0.76,p=0.0177,95%CI:0.58-0.98)、总生存期显著延长(中位OS:6.2个月[双边检验95%CI:5.3-7.2] vs 4.7个月[双边检验95%CI:4.0-5.5]);Vanflyta治疗组估计的1年生存率为27%,挽救性化疗组为20%。安全性方面,接受Vanflyta治疗的患者最常见的药物不良反应是恶心(33.2%,80/241例)、心电图QT延长(24.9%,60/241例)、贫血(24.9%,60/241例)和血小板减少(21.2%,51/241例)。

来自日本II期研究的数据显示,在中期分析时,已经达到了预先指定的符合完全缓解率的主要终点。该研究中Vanflyta的疗效和安全性与QuANTUM-R研究中一致。

    第一三共肿瘤学功能负责人裁兼研发主管Wataru Takasaki表示,“Vanflyta获得批准,将为日本复发/难治性FLT3-ITD AML患者提供一种重要的新治疗方案,该方案专门针对疾病的潜在驱动因素,与化疗相比具有已证实的生存效益。我们很自豪Vanflyta是我们承诺到2025年实现推出七个新分子实体中的第一个,目标是将科学转化为癌症患者的创新疗法。”

微信截图_20190620224516.png

       Vanflyta的活性药物成分quizartinib属于第二代FLT3抑制剂,该药是一种口服小分子受体酪氨酸激酶抑制剂,选择性靶向抑制FLT3。在美国,quizartinib已获FDA授予治疗复发性/难治性FLT3-ITD AML成人患者的突破性药物资格、治疗复发性/难治性AML的快速通道地位。此外,quizartinib在美国、欧盟均被授予了治疗AML的孤儿药资格,在日本被授予了治疗FLT3突变AML的孤儿药资格。

   除了接受FDA的优先审查之外,Vanflyta目前也正在接受欧洲药品管理局(EMA)的加速评估。AML是一种侵袭性血液和骨髓癌症,导致患者体内功能失常的癌变白细胞不受控制地增生和积累,并影响正常血细胞的生成。FLT3基因突变是AML最常见的基因异常改变之一,其中FLT3-ITD是最常见的FLT3突变,影响约1/4的AML患者。FLT3-ITD是白血病高负担、预后差并对AML患者疾病管理有显著影响的一种驱动突变。与未携带FLT3-ITD突变的AML患者相比,FLT3-ITD AML患者总体预后更差,包括复发率增加、复发后死亡风险增加、造血干细胞移植后复发的可能性更高。


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