{"id":15573,"date":"2021-11-15T10:00:22","date_gmt":"2021-11-15T09:00:22","guid":{"rendered":"https:\/\/convergences.online\/hemato\/?p=15573"},"modified":"2024-12-11T14:07:06","modified_gmt":"2024-12-11T13:07:06","slug":"validation-a-long-terme-de-librutinib-dans-la-maladie-de-waldenstrom-en-rechute","status":"publish","type":"post","link":"https:\/\/www.hematostat.net\/en\/validation-a-long-terme-de-librutinib-dans-la-maladie-de-waldenstrom-en-rechute\/","title":{"rendered":"Validation \u00e0 long terme de l\u2019ibrutinib dans la maladie de Waldenstr\u00f6m 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:1302px;margin-left: calc(-5% \/ 2 );margin-right: calc(-5% \/ 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:2.375%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:2.375%;--awb-width-medium:100%;--awb-spacing-right-medium:2.375%;--awb-spacing-left-medium:2.375%;--awb-width-small:100%;--awb-spacing-right-small:2.375%;--awb-spacing-left-small:2.375%;\"><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) : R28<\/p>\n<\/p>\n<p>Suivi \u00e0 long terme de la monoth\u00e9rapie par ibrutinib dans la maladie de Waldenstr\u00f6m symptomatique pr\u00e9c\u00e9demment trait\u00e9.<\/p>\n<p><em>Long-Term Follow-Up of Ibrutinib Monotherapy in Symptomatic, Pr\u00e9c\u00e9dently Treated Patients With Waldenstr\u00f6m Macroglobulinemia.<\/em><\/p>\n<p><a href=\"https:\/\/ascopubs.org\/doi\/full\/10.1200\/JCO.20.00555\">Treon et al. Long-Term Follow-Up of Ibrutinib Monotherapy in Symptomatic, Pr\u00e9c\u00e9dently Treated Patients With Waldenstr\u00f6m Macroglobulinemia. JCO 2020. 39:4 565-575. DOI :https:\/\/doi.org\/10.1200\/JCO.20.00555<\/a><\/p>\n<\/p>\n<h3>R\u00e9sum\u00e9 de l\u2019\u00e9tude<\/h3>\n<p>Un essai de phase 3 avait montr\u00e9 l\u2019efficacit\u00e9 de l\u2019ibrutinib en continu \u00e0 420 mg\/j, inhibiteur de la Bruton kinase, chez 63 patients avec maladie de Waldenstr\u00f6m (MW) en rechute<sup>1<\/sup>, faisant de ce traitement le principal traitement de deuxi\u00e8me ligne. Le suivi m\u00e9dian \u00e9tait de 19 mois. Cette nouvelle \u00e9tude est une pr\u00e9sentation des r\u00e9sultats \u00e0 plus long terme, avec un suivi m\u00e9dian de 59 mois. Le taux de r\u00e9ponse globale est de 90 % dont 79 % de r\u00e9ponse majeure. La survie globale \u00e0 5 ans \u00e9tait de 87 %. La tol\u00e9rance \u00e9tait bonne, \u00e0 noter la survenue d\u2019une fibrillation atriale chez 12.7 % des patients.<\/p>\n<h3>Dans nos pratiques<\/h3>\n<p>Cette \u00e9tude valide l\u2019excellente efficacit\u00e9 de l\u2019ibrutinib dans la MW et sa place en deuxi\u00e8me ligne de traitement. Attention \u00e0 une efficacit\u00e9 moindre chez les rares patients MYD88<sup>WT<\/sup>, avec une survie sans progression de moins de 6 mois.<\/p>\n<h3>Le regard du statisticien<\/h3>\n<p>Cette \u00e9tude au long cours permet non seulement de r\u00e9actualiser l\u2019efficacit\u00e9 et la toxicit\u00e9 de l\u2019ibrutinib, mais \u00e9galement d\u2019analyser les facteurs de risques de survie globale et tout particuli\u00e8rement la survie sans progression par le biais de mod\u00e8les de Cox. Mis \u00e0 part le <em>flowchart <\/em>incomplet (il manque le d\u00e9tail de 6 autres patients n\u2019ayant pas compl\u00e9t\u00e9 l\u2019\u00e9tude), cette publication reconfirme l\u2019int\u00e9r\u00eat de l\u2019ibrutinib en particulier chez les patients MYD88 mut\u00e9 x CXCR4 <em>wild type <\/em>dont la r\u00e9ponse majeure intervient \u00e0 1.8 mois de suivi m\u00e9dian.<\/p><\/p>\n<\/div><\/div><\/div><\/div><\/div>","protected":false},"excerpt":{"rendered":"","protected":false},"author":2,"featured_media":15574,"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":[179,92,96,180],"ppma_author":[442],"class_list":["post-15573","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-revue-de-presse","tag-flowchart","tag-ibrutinib","tag-maladie-de-waldenstrom","tag-modele-de-cox","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\/15573","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=15573"}],"version-history":[{"count":1,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts\/15573\/revisions"}],"predecessor-version":[{"id":18195,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts\/15573\/revisions\/18195"}],"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=15573"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/categories?post=15573"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/tags?post=15573"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/ppma_author?post=15573"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}