FLT3抑制剂治疗急性髓系白血病的研究进展

Advances in the treatment of acute myeloid leukaemia with FLT3 inhibitors

急性髓系白血病(AML)是一种高度异质性的血液系统恶性肿瘤,其中FMS样酪氨酸激酶3(FLT3)基因突变是AML常见的基因突变之一,伴FLT3基因突变的患者复发率高、预后差,因此FLT3成为治疗AML最具潜力的靶点之一。目前已有第一代、第二代抑制剂先后进入临床研究,其中米哚妥林(Midostaurin)、吉瑞替尼(Gilteritinib)、奎扎替尼(Quizartinib)已被批准用于AML患者的治疗。FLT3抑制剂与标准化疗药物联合使用可提高疾病缓解率,在后续的维持治疗或移植患者中也有较好疗效,可改善患者的整体预后,但部分患者可出现耐药性,研发新的FLT3抑制剂或FLT3抑制剂与其他药物联合应用可减少耐药性的产生。该文对常见的FLT3抑制剂在AML治疗中的研究进展进行综述,以期为临床提供参考。

Acute myeloid leukaemia(AML)is a highly heterogeneous haematological malignancy,in which FMS like tyrosine kinase 3(FLT3)gene mutation is one of the common gene mutations in AML.Patients with FLT3 mutations have a high relapse rate and poor prognosis,making FLT3 one of the most promising targets for the treatment of AML.At present,the first and second generation inhibitors have entered clinical research successively,among which Midostaurin,Giletitinib,and Quizartinib have been approved for the treatment of AML patients.The combination of FLT3 inhibitors with standard chemotherapeutic drugs can improve the remission rate of the disease,and also have better efficacy in subsequent maintenance therapy or transplant patients,which can improve the overall prognosis of patients.However,some patients may develop drug resistance.Developing new FLT3 inhibitors or combining FLT3 inhibitors with other drugs can reduce the development of drug resistance.This article reviewed the research progress of common FLT3 inhibitors in the treatment of AML,in order to provide reference for clinical practice.