{"id":15101,"date":"2021-06-07T14:51:23","date_gmt":"2021-06-07T12:51:23","guid":{"rendered":"https:\/\/convergences.online\/hemato\/?p=15101"},"modified":"2024-12-11T13:27:47","modified_gmt":"2024-12-11T12:27:47","slug":"idelalisib-le-baroud-dhonneur","status":"publish","type":"post","link":"https:\/\/www.hematostat.net\/en\/idelalisib-le-baroud-dhonneur\/","title":{"rendered":"Idelalisib, le baroud d\u2019honneur"},"content":{"rendered":"<div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 fusion-flex-container nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:calc( 1240px + 0px );margin-left: calc(-0px \/ 2 );margin-right: calc(-0px \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:0px;--awb-margin-bottom-large:0px;--awb-spacing-left-large:0px;--awb-width-medium:100%;--awb-spacing-right-medium:0px;--awb-spacing-left-medium:0px;--awb-width-small:100%;--awb-spacing-right-small:0px;--awb-spacing-left-small:0px;\"><div class=\"fusion-column-wrapper fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-1\"><p>R\u00e9f. : HematoStat.net ; 2 (2) : R19<\/p>\n<p><a href=\"https:\/\/ashpublications.org\/bloodadvances\/article\/5\/9\/2438\/475899\/Obinutuzumab-and-idelalisib-in-symptomatic\"><em>Tomowiak C, Poulain S, Herbaux C, Perrot A, Mah\u00e9 B, Morel P, Aurran T, Tournilhac O, Lepr\u00eatre S, Assaad S, Villemagne B, Casasnovas O, Nollet D, Roos- Weil D, Chevret S, Leblond V. Obinutuzumab and idelalisib in symptomatic patients with relapsed\/refractory Waldenstr\u00f6m macroglobulinemia. Blood Adv. 2021 May 11;5(9):2438-2446. doi: 10.1182\/bloodadvances.2020003895. PMID: 33961019; PMCID: PMC8114554.<\/em><\/a><\/p>\n<h3><strong>R\u00e9sum\u00e9 de l\u2019article :<\/strong><\/h3>\n<p>Les auteurs pr\u00e9sentent les r\u00e9sultats d\u2019un essai de phase II du FILO \u00e9valuant la s\u00e9curit\u00e9 et l\u2019efficacit\u00e9 d\u2019un traitement associant obinutuzumab (O) et idelalisib (Idela) chez 48 patients atteints de maladie de Waldenstr\u00f6m en rechute ou r\u00e9fractaire (R\/R). Le traitement comportait une phase d\u2019induction de 6 cycles d\u2019Idela + O suivi de I seul durant 2 ans. Vingt-sept patients ont particip\u00e9 \u00e0 la phase de maintenance.<\/p>\n<p>Le taux de r\u00e9ponse global et le taux de r\u00e9ponse majeure sont respectivement de 71,4 % et 65,3 %. Avec un suivi m\u00e9dian de 25,9 mois, la PFS m\u00e9diane est de 35.4 mois. Il ne semble pas y avoir d\u2019impact des g\u00e9notypes de <em>CXCR4 <\/em>sur les r\u00e9ponses et la survie mais un impact des mutations de <em>TP53 <\/em>sur la survie. Vingt-six patients ont d\u00fb arr\u00eater l\u2019\u00e9tude en raison de toxicit\u00e9s : neutrop\u00e9nie (9,4 %), diarrh\u00e9e (8,6 %) toxicit\u00e9 h\u00e9patique (9,3 %).<\/p>\n<h3><strong>Dans nos pratiques :<\/strong><\/h3>\n<p>Cette \u00e9tude montre la possibilit\u00e9 d\u2019utiliser cette association mais au prix d\u2019une toxicit\u00e9 importante et limitante. Son applicabilit\u00e9 est faible dans la mesure o\u00f9 seuls 3 patients avaient ant\u00e9rieurement \u00e9t\u00e9 trait\u00e9s par ibrutinib, et que ces r\u00e9sultats semblent moins bon que l\u2019inhibiteur de BTK utilis\u00e9 seul ou en association avec un anti-CD20 en situation R\/R.<\/p>\n<h3><strong>Le regard du statisticien :<\/strong><\/h3>\n<p>Le crit\u00e8re de jugement de l\u2019\u00e9tude \u00e9tait la PFS et l\u2019objectif initial (m\u00e9diane de PFS &gt; 25 mois) a \u00e9t\u00e9 atteint. La men\u00e9e de l\u2019\u00e9tude a \u00e9t\u00e9 impact\u00e9e par une toxicit\u00e9 importante. Point int\u00e9ressant :  l\u2019analyse Bayesienne des effets secondaires a montr\u00e9 de fa\u00e7on quasi certaine que le \u00be des patients est impact\u00e9 par ces effets secondaires.<\/p>\n<p>L\u2019impact pronostique des anomalies mol\u00e9culaires doit \u00eatre interpr\u00e9t\u00e9 avec pr\u00e9caution en raison de la petite taille de l\u2019\u00e9chantillon, m\u00eame si les patients CSCR4<sup>MUT <\/sup>b\u00e9n\u00e9ficient possiblement de cette association.<\/p>\n<\/div><\/div><\/div><\/div><\/div>","protected":false},"excerpt":{"rendered":"","protected":false},"author":9,"featured_media":15102,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_uf_show_specific_survey":0,"_uf_disable_surveys":false,"footnotes":""},"categories":[36],"tags":[95,96,97],"ppma_author":[451],"class_list":["post-15101","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-revue-de-presse","tag-idelalisib","tag-maladie-de-waldenstrom","tag-obinutuzumab","author-vincent-levy"],"aioseo_notices":[],"authors":[{"term_id":451,"user_id":9,"is_guest":0,"slug":"vincent-levy","display_name":"Vincent LEVY","avatar_url":{"url":"https:\/\/www.hematostat.net\/wp-content\/uploads\/2023\/06\/Capture-decran-2021-05-07-a-13.21.23.png","url2x":"https:\/\/www.hematostat.net\/wp-content\/uploads\/2023\/06\/Capture-decran-2021-05-07-a-13.21.23.png"},"first_name":"","last_name":"","user_url":"","description":"H\u00e9matologue, PU, PH en Pharmacie Clinique. <br>\r\nResponsable de l\u2019Unit\u00e9 de Recherche Clinique et du Centre de Recherche Clinique du GH de Seine-Saint-Denis, H\u00f4pital Avicenne. <br>\r\nMembre du CA et du CS du FILO. <br>\r\n<strong>Expertise : <\/strong>Leuc\u00e9mie lympho\u00efde chronique, essais cliniques.<br>\r\n<strong>Liens d'int\u00e9r\u00eat au 01\/01\/2023: <\/strong> Abbvie, AstraZeneca, Janssen.<br>\r\n<strong>Correspondance : <\/strong>H\u00f4pital Avicenne CRC\/URC, 125 rue de Stalingrad 96000 Bobigny."}],"_links":{"self":[{"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts\/15101","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/users\/9"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/comments?post=15101"}],"version-history":[{"count":1,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts\/15101\/revisions"}],"predecessor-version":[{"id":18186,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts\/15101\/revisions\/18186"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/"}],"wp:attachment":[{"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/media?parent=15101"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/categories?post=15101"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/tags?post=15101"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/ppma_author?post=15101"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}