{"id":16302,"date":"2022-07-12T20:49:28","date_gmt":"2022-07-12T18:49:28","guid":{"rendered":"https:\/\/convergences.online\/hemato\/?p=16302"},"modified":"2024-12-11T15:32:57","modified_gmt":"2024-12-11T14:32:57","slug":"cinetique-de-la-mrd","status":"publish","type":"post","link":"https:\/\/www.hematostat.net\/en\/cinetique-de-la-mrd\/","title":{"rendered":"Cin\u00e9tique de la MRD"},"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 ; 3 (3) : R59<\/p>\n<p><em> <\/em><\/p>\n<p><a href=\"https:\/\/www.practiceupdate.com\/content\/minimal-residual-disease-dynamics-after-venetoclax-obinutuzumab-treatment\/128519\"><i>Minimal Residual Disease Dynamics after Venetoclax-Obinutuzumab Treatment: Extended Off-Treatment Follow-up From the Randomized CLL14 Study. Al-Sawaf O, Zhang C, Lu T, Liao MZ, Panchal A, Robrecht S, Ching T, Tandon M, Fink AM, Tausch E, Schneider C, Ritgen M, B\u00f6ttcher S, Kreuzer KA, Chyla B, Miles D, Wendtner CM, Eichhorst B, Stilgenbauer S, Jiang Y, Hallek M, Fischer K. J Clin Oncol. 2021 Dec 20;39(36):4049-4060. doi: 10.1200\/JCO.21.01181. Epub 2021 Oct 28. PMID: 34709929; PMCID: PMC8678026.<\/i><\/a><\/p>\n<\/p>\n<p><strong>R\u00e9sum\u00e9 de l\u2019article<\/strong><\/p>\n<p>L\u2019essai CLL14, comparant en premi\u00e8re ligne l\u2019association v\u00e9n\u00e9toclax \u2013obintuzumab (Ven-Obi) sur une dur\u00e9e de 1 an \u00e0 chlrorambucil-obinutuzumab (Clb-Obi), a permis d\u2019\u00e9tablir la premi\u00e8re comme une option valide dans le traitement des patients atteints de LLC.<\/p>\n<p>On rappelle que 432 patients ont \u00e9t\u00e9 randomis\u00e9s 1:1 entre les 2 traitement (i.e. 6 cycles d\u2019obinutzumab associ\u00e9 soit \u00e0 12 cycles de v\u00e9n\u00e9toclax soit 12 cycles de chlorambucil). Le crit\u00e8re de jugement principal \u00e9tait la PFS et les crit\u00e8res secondaires clefs la MRD ind\u00e9tectable et la survie globale. L\u2019objet de cet article \u00e9tait d\u2019analyser la dynamique de la maladie r\u00e9siduelle \u00e0 l\u2019aide d\u2019une approche de mod\u00e9lisaiton<\/p>\n<p>\u00c0 3 mois de la fin du traitement 40% des patients trait\u00e9s par Ven-Obi avaient une MRD ind\u00e9tectable (7 % apr\u00e8s Clb-Obi). Le temps de doublement m\u00e9dian de la MRD \u00e9tait plus lent apr\u00e8s Ven-Obi qu\u2019apr\u00e8s Clb-Obi (80 <em>vs<\/em> 69 jours).<\/p>\n<p>Avec une m\u00e9diane de suivi de 52.4 mois, la PFS reste meilleure pour les patients trait\u00e9s par Ven-Obi (hazard ratio 0.33; 95 % IC, 0.25 to 0.45; p : 0.0001). La PFS pour les patients apr\u00e8s Ven-Obi est estim\u00e9e 74 % \u00e0 4 ans <em>versus<\/em> 35.4 % apr\u00e8s Clb-Obi. Il n\u2019a pas \u00e9t\u00e9 observ\u00e9 de diff\u00e9rence de survie ou de nouveau signal de toxicit\u00e9.<\/p>\n<p><strong>Dans nos pratiques<\/strong><\/p>\n<p>Il n\u2019y pas de cons\u00e9quence directe sur la pratique de cet article qui fournit cependant de tr\u00e8s int\u00e9ressantes informations sur la cin\u00e9tique de repopulation apr\u00e8s arr\u00eat de traitement dans la LLC. Il confirme par ailleurs les bons r\u00e9sultats de de l\u2019association Ven-Obi en premi\u00e8re ligne<\/p>\n<p><strong>Regard du statisticien<\/strong><\/p>\n<p>Les mod\u00e8les utilis\u00e9s pour d\u00e9crire la cin\u00e9tique de croissance semblent valides, et comme le commentent les auteurs dans la discussion, n\u00e9cessitent d\u2019\u00eatre cependant valid\u00e9 dans d\u2019autres cohortes de patients.<\/p>\n<\/div><\/div><\/div><\/div><\/div>","protected":false},"excerpt":{"rendered":"","protected":false},"author":9,"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":[334,225,97,160],"ppma_author":[451],"class_list":["post-16302","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-revue-de-presse","tag-essais-de-phase-3","tag-mrd","tag-obinutuzumab","tag-venetoclax","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\/16302","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=16302"}],"version-history":[{"count":1,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts\/16302\/revisions"}],"predecessor-version":[{"id":18230,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts\/16302\/revisions\/18230"}],"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=16302"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/categories?post=16302"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/tags?post=16302"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/ppma_author?post=16302"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}