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AML 治疗的新时代:当前标准与新兴靶点

英文原题:The new era of AML therapy: current standards and emerging targets.

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The new era of AML therapy: current standards and emerging targets.

PubMed 2026/04/17(内容时间) Int J Clin Oncol Q3 · IF 3(JCR 2025)

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中文摘要

过去十年间,AML的治疗已从统一的7 + 3方案演变为个体化治疗策略。这一转变将分子遗传学特征与临床体能状态相结合,其驱动力来自对AML基因组学的阐明以及选择性靶向药物的研发。关键进展包括将FLT3抑制剂整合入强化化疗,以及venetoclax的出现。venetoclax与去甲基化药物联用时,重新定义了老年或不适合强化治疗患者的标准治疗。

此外,IDH1/2抑制剂和menin抑制剂分别为由IDH1/2突变以及KMT2A重排或NPM1突变所定义的分子亚群提供了强效治疗选择。脂质体剂型CPX-351,以及CC-486和口服decitabine/cedazuridine等口服制剂的创新进一步优化了治疗给药方式,并改善了患者的生活质量。尽管取得了这些突破,内在的克隆异质性和耐药突变,尤其是TP53突变,仍是重大挑战。当前研究正积极探索新一代抑制剂、抗体偶联药物以及BiTEs和CAR-T 细胞等细胞免疫疗法。本综述总结了AML近期药物治疗的演进,并讨论了这些新兴疗法如何使我们更接近实现根治这一终极目标。

展开英文摘要原文

Over the past decade, AML therapy has evolved from the uniform "7 + 3" regimen toward a personalized approach. This transition integrates molecular genetic profiles with clinical fitness, driven by the genomic elucidation of AML and the development of selective targeted agents. Key advancements include the integration of FLT3 inhibitors into intensive chemotherapy and the emergence of venetoclax. When combined with hypomethylating agents, venetoclax has redefined the standard of care for older or unfit patients.

Furthermore, IDH1/2 inhibitors and menin inhibitors have provided potent options for molecular subsets defined by IDH1/2 mutations and KMT2A rearrangements or NPM1 mutations, respectively. Innovations such as the liposomal formulation CPX-351 and oral formulations of CC-486 and oral decitabine/cedazuridine have further optimized treatment delivery and improved patient quality of life.

Despite these breakthroughs, intrinsic clonal heterogeneity and drug-resistant mutations, particularly TP53 mutation, remain significant challenges. Current research is actively exploring next-generation inhibitors, antibody-drug conjugates, and cellular immunotherapies such as BiTEs and CAR-T cells. This review summarizes the recent pharmacological evolution in AML and discusses how these emerging therapies bring us closer to the ultimate goal of achieving a definitive cure.

论文信息

作者
Hosono N
单位
Department of Hematology and Oncology, University of Fukui, 23-3, Shimoaizuki, Matsuoka, Eiheiji, Fukui, 910-1193, Japan. hosono@u-fukui.ac.jp.Japan
文献类型
综述
期刊
International journal of clinical oncology2026 Jul
原文标识
PubMed 41995989 · DOI 10.1007/s10147-026-03038-7