{"id":15310,"date":"2021-11-08T07:52:53","date_gmt":"2021-11-08T06:52:53","guid":{"rendered":"https:\/\/convergences.online\/hemato\/?p=15310"},"modified":"2024-12-11T14:02:23","modified_gmt":"2024-12-11T13:02:23","slug":"validation-a-long-terme-du-traitement-de-premiere-ligne-du-lymphome-de-hodgkin-avance-par-4-cures-de-beacopp-escalade","status":"publish","type":"post","link":"https:\/\/www.hematostat.net\/en\/validation-a-long-terme-du-traitement-de-premiere-ligne-du-lymphome-de-hodgkin-avance-par-4-cures-de-beacopp-escalade\/","title":{"rendered":"Validation \u00e0 long terme du traitement de premi\u00e8re ligne du lymphome de Hodgkin avanc\u00e9 par 4 cures de BEACOPP escalad\u00e9"},"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 (4) : R25<\/p>\n<p>Traitement guid\u00e9 par la TEP du lymphome de Hodgkin avanc\u00e9 (essai H18) : suivi d\u2019un essai international, ouvert, randomis\u00e9, de phase 3.<\/p>\n<p><em>PET-guided eBEACOPP treatment of advanced-stage Hodgkin lymphoma (HD18): follow-up analysis of an international, open-label, randomised, phase 3 trial.<\/em><\/p>\n<p><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/34048679\/\"><em>Kreissel et al. <\/em><em>PET-guided eBEACOPP treatment of advanced-stage Hodgkin lymphoma (HD18): follow-up analysis of an international, open-label, randomised, phase 3 trial. Lancet oncol 2021<\/em><em>. <\/em><em>Jun;8(6):<\/em><em>e398-409.<\/em><\/a><\/p>\n<h3>R\u00e9sum\u00e9<\/h3>\n<p>Cette \u00e9tude est un suivi \u00e0 long terme de l\u2019essai H18, essai international de phase III randomis\u00e9 qui a montr\u00e9 l\u2019efficacit\u00e9 en termes de survie sans progression (PFS) et la tol\u00e9rance d\u2019une strat\u00e9gie guid\u00e9e par la TEP chez des patients atteints de lymphome de Hodgkin avanc\u00e9. Apr\u00e8s 2 cycles de BEACOPP escalad\u00e9 (eBEACOPP), les patients avec TEP 2 n\u00e9gative \u00e9taient randomis\u00e9s entre 2 ou 6 cycles suppl\u00e9mentaires. Le crit\u00e8re de non-inf\u00e9riorit\u00e9 \u00e9tait atteint.<\/p>\n<p>Un amendement a modifi\u00e9 le protocole en 2011 \u00e0 la suite des r\u00e9sultats de l\u2019essai H15. Le traitement de r\u00e9f\u00e9rence a \u00e9t\u00e9 diminu\u00e9 en intensit\u00e9 de 8 \u00e0 6 cycles de eBEACOPP, le traitement exp\u00e9rimental est rest\u00e9 identique \u00e0 4 eBEACOPP.<\/p>\n<p>Dans le sous-groupe de patients trait\u00e9s apr\u00e8s l\u2019amendement avec moins d\u2019intensit\u00e9, et avec une TEP 2 n\u00e9gative, la PFS \u00e0 5 ans \u00e9tait de 90.9 % [IC95 % 86.8-95.1] chez les 202 patients trait\u00e9s par 6 eBEACOPP et de 91.0 % [IC95 % 86.6-95.5] chez les 200 patients trait\u00e9s par 4 eBEACOPP. Le crit\u00e8re de non-inf\u00e9riorit\u00e9 \u00e9tait atteint.<\/p>\n<h3>Dans nos pratiques<\/h3>\n<p>\u00c0 la suite de l\u2019essai AHL 2011, la r\u00e9f\u00e9rence en France dans le traitement des Hodgkin de stade avanc\u00e9 est une strat\u00e9gie guid\u00e9e par la TEP apr\u00e8s 2 cures de eBEACOPP (tous les 21 jours), avec 4 cures suppl\u00e9mentaires de eBEACOPP en cas de TEP positive et 4 cycles d\u2019ABVD (tous les 28 jours) en cas de TEP 2 n\u00e9gative.<\/p>\n<p>\u00c0 la suite de cet essai H18, une strat\u00e9gie alternative plus courte, mais plus intense, peut aussi \u00eatre envisag\u00e9e chez certains patients. En cas de TEP 2 n\u00e9gative apr\u00e8s 2 eBEACOPP, il est possible de r\u00e9aliser 2 cures suppl\u00e9mentaires, soit un total de 4 eBEACOPP.<\/p>\n<h3>Le regard du statisticien<\/h3>\n<p>Le crit\u00e8re principal se base sur la survie sans progression \u00e0 un suivi assez lointain de 5 ans avec un d\u00e9lai de suivi m\u00e9dian satisfaisant. La randomisation a \u00e9t\u00e9 stratifi\u00e9e sur plusieurs param\u00e8tres et la m\u00e9thodologie statistique a scrupuleusement pris en compte l\u2019amendement diminuant le nombre de cycles. En bref : des r\u00e9sultats solides et probants.<\/p>\n<\/div><\/div><\/div><\/div><\/div>","protected":false},"excerpt":{"rendered":"","protected":false},"author":2,"featured_media":15311,"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":[173,174,52,175],"ppma_author":[442],"class_list":["post-15310","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-revue-de-presse","tag-avance","tag-beacopp-escalade","tag-lymphome-de-hodgkin","tag-tep","author-marion"],"aioseo_notices":[],"authors":[{"term_id":442,"user_id":2,"is_guest":0,"slug":"marion","display_name":"HematoStat.net (M)","avatar_url":{"url":"https:\/\/www.hematostat.net\/wp-content\/uploads\/2024\/01\/favicon-hematoStat.png","url2x":"https:\/\/www.hematostat.net\/wp-content\/uploads\/2024\/01\/favicon-hematoStat.png"},"first_name":"HematoStat.net (M)","last_name":"","user_url":"","description":""}],"_links":{"self":[{"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts\/15310","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\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/comments?post=15310"}],"version-history":[{"count":1,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts\/15310\/revisions"}],"predecessor-version":[{"id":18192,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts\/15310\/revisions\/18192"}],"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=15310"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/categories?post=15310"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/tags?post=15310"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/ppma_author?post=15310"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}