{"id":15313,"date":"2021-11-08T07:55:27","date_gmt":"2021-11-08T06:55:27","guid":{"rendered":"https:\/\/convergences.online\/hemato\/?p=15313"},"modified":"2024-12-11T14:03:35","modified_gmt":"2024-12-11T13:03:35","slug":"un-inhibiteur-de-pi3-kinase-intraveineux-en-association-au-rituximab-pour-les-lymphomes-b-indolents-en-rechute","status":"publish","type":"post","link":"https:\/\/www.hematostat.net\/en\/un-inhibiteur-de-pi3-kinase-intraveineux-en-association-au-rituximab-pour-les-lymphomes-b-indolents-en-rechute\/","title":{"rendered":"Un inhibiteur de PI3-Kinase intraveineux en association au rituximab pour les lymphomes B indolents en rechute"},"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) : R26<\/p>\n<p>Copanlisib plus rituximab <em>versus <\/em>placebo et rituximab chez des patients avec lymphome non Hodgkinien indolent en rechute (CHRONOS-3) : un essai de phase 3 randomis\u00e9, contre placebo, en double aveugle.<\/p>\n<p><em>Copanlisib plus rituximab versus placebo plus rituximab in patients with relapsed indolent non-Hodgkin lymphoma (CHRONOS-3): a double blind, randomised, placebo-controlled, phase 3 trial.<\/em><\/p>\n<p><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/33848462\/\"><em>Matasar et al. Copanlisib plus rituximab versus placebo plus rituximab in patients with relapsed indolent non-Hodgkin lymphoma (CHRONOS-3) : a double blind, randomised, placebo-controlled, phase 3 trial. Lancet oncol 2021. May 22(5) :678-89.<\/em><\/a><\/p>\n<h3>R\u00e9sum\u00e9<\/h3>\n<p>Le copanlisib est un inhibiteur de PI3-Kinase intraveineux ayant montr\u00e9 son efficacit\u00e9 en monoth\u00e9rapie. Dans cet essai de phase 3, 307 patients avec lymphome B indolent en rechute ont \u00e9t\u00e9 randomis\u00e9s pour recevoir du copanlisib (60mg J1 J8 J15, cycles de 28 jours) jusqu\u2019\u00e0 progression associ\u00e9 au rituximab 375 mg\/m\u00b2 J1 J8 J15 J22 au premier cycle puis au J1 des cycles 3,5,7,9 ; 151 patients ont re\u00e7u en double aveugle un placebo associ\u00e9 au rituximab selon les m\u00eames modalit\u00e9s. Apr\u00e8s un suivi m\u00e9dian de 19.2 mois, la survie sans progression (crit\u00e8re de jugement principal) \u00e9tait de 21.5 mois [IC : 95 % ; 17.8-33.0] dans le groupe copanlisib et de 13.8 mois [IC : 95% ; 10.2-17.5] dans le groupe placebo, avec un <acronym title=\"rapport des risques instantan\u00e9s, mesure d\u2019effet utilis\u00e9e dans les mod\u00e8les de r\u00e9gression pour donn\u00e9es de survie\">hazard ratio<\/acronym> \u00e0 0.52 [IC95 % 0.39-0.69], p &lt;0.001. La tol\u00e9rance \u00e9tait surtout marqu\u00e9e par la survenue d\u2019hyperglyc\u00e9mie (56% <em>vs.<\/em>8%) et d\u2019hypertension art\u00e9rielle (40 % <em>vs <\/em>9 %) dans le groupe copanlisib.<\/p>\n<h3>Dans nos pratiques<\/h3>\n<p>Le copanlisib associ\u00e9 au rituximab est une alternative sans chimioth\u00e9rapie int\u00e9ressante pour le traitement de patients en rechute de lymphome B indolent, qui sont souvent \u00e2g\u00e9s et\/ou fragile. Une vigilance accrue vis-\u00e0-vis des risques d\u2019hyperglyc\u00e9mie et d\u2019hypertension art\u00e9rielle est n\u00e9cessaire.<\/p>\n<h3>Le regard du statisticien<\/h3>\n<p>La publication de cet essai de phase 3 tr\u00e8s classique va droit au but en pr\u00e9sentant le descriptif comparatif des deux bras de l\u2019\u00e9tude avec et sans placebo, visualisations par des courbes de Kaplan-Meier (PFS, d\u00e9lai jusque la progression et dur\u00e9e de r\u00e9ponse), <em>forest plot <\/em>en fonction de divers sous-groupes et table des <em>adverse events<\/em>. Tous les r\u00e9sultats vont dans le sens d\u2019une am\u00e9lioration du devenir du patient, et m\u00eame mieux que pr\u00e9vu d\u2019apr\u00e8s les hypoth\u00e8ses de d\u00e9part (si ce n\u2019est comme cela a \u00e9t\u00e9 soulign\u00e9 une augmentation importante des cas d\u2019hyperglyc\u00e9mie et hypertension).<\/p>\n<\/div><\/div><\/div><\/div><\/div>","protected":false},"excerpt":{"rendered":"","protected":false},"author":2,"featured_media":15314,"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":[176,177,178],"ppma_author":[442],"class_list":["post-15313","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-revue-de-presse","tag-copanlisib","tag-lymphome-non-hodgkinien-b-indolent","tag-pi3k-inhibitor","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\/15313","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=15313"}],"version-history":[{"count":1,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts\/15313\/revisions"}],"predecessor-version":[{"id":18193,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts\/15313\/revisions\/18193"}],"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=15313"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/categories?post=15313"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/tags?post=15313"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/ppma_author?post=15313"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}