{"id":16689,"date":"2023-03-29T13:24:40","date_gmt":"2023-03-29T11:24:40","guid":{"rendered":"https:\/\/convergences.online\/hemato\/?p=16689"},"modified":"2024-12-11T18:50:21","modified_gmt":"2024-12-11T17:50:21","slug":"therapies-sequentielles-dans-les-lymphomes-b-diffus-a-grandes-cellules","status":"publish","type":"post","link":"https:\/\/www.hematostat.net\/en\/therapies-sequentielles-dans-les-lymphomes-b-diffus-a-grandes-cellules\/","title":{"rendered":"Th\u00e9rapies s\u00e9quentielles dans les lymphomes B diffus \u00e0 grandes cellules"},"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 ; 4 (1) : R72<\/p>\n<p style=\"font-weight: 400;\"><a href=\"https:\/\/ascopubs.org\/doi\/abs\/10.1200\/jco.22.00597\"><em>Westin J, Davis RE, Feng L et al. <\/em><em>Smart Start: Rituximab, Lenalidomide, and Ibrutinib in Patients With Newly Diagnosed Large B-Cell Lymphoma. <\/em><em>J Clin Oncol 41:745-755.<\/em><\/a><\/p>\n<p style=\"font-weight: 400;\"><strong>R\u00e9sum\u00e9 de l\u2019article<\/strong><\/p>\n<p style=\"font-weight: 400;\">Cette essai de phase 2 ouverte a \u00e9t\u00e9 men\u00e9e par le <i>MD Anderson Cancer Center<\/i>, \u00e9tudiant un sch\u00e9ma rituximab-l\u00e9nalidomide-ibrutinib (RLI) seul (2 cycles) puis en association avec une chimioth\u00e9rapie par CHOP ou EPOCH dans les lymphomes B diffus \u00e0 grandes cellules post centre germinatif. Dans les 60 patients inclus, le taux de r\u00e9ponse globale apr\u00e8s 2 cycles de RLI seul \u00e9tait de 86 % (dont 36 % de r\u00e9ponse compl\u00e8te), et de 100 % (dont 95 % de r\u00e9ponse compl\u00e8te) apr\u00e8s l\u2019adjonction des 6 cycles de chimioth\u00e9rapie. La PFS \u00e0 2 ans \u00e9tait de IC91 % [84-99]. Deux patients sont d\u00e9c\u00e9d\u00e9s de complications infectieuses.<\/p>\n<p><strong>Dans nos pratiques<\/strong><\/p>\n<p>Dans cette \u00e9tude, l\u2019adjonction de 3 th\u00e9rapies cibl\u00e9es ayant montr\u00e9 une efficacit\u00e9 mod\u00e9r\u00e9e en monoth\u00e9rapie dans ce sous type de lymphome de mauvais pronostic a permis des taux de r\u00e9ponse et de PFS \u00e0 2 ans importants. Si une comparaison aux taux historiquement retrouv\u00e9s dans ce sous-type sont limit\u00e9s par l\u2019absence de comparaison directe d\u2019une part, mais \u00e9galement par la pr\u00e9valence importante (37 %) de patients avec des maladies limit\u00e9es (stade 1-2), cette \u00e9tude est int\u00e9ressante par l\u2019originalit\u00e9 du sch\u00e9ma th\u00e9rapeutique employ\u00e9, permettant une \u00e9valuation double des drogues \u00ab tests \u00bb d\u2019abord seules puis en association avec le traitement standard. Ce sch\u00e9ma pourrait permettre notamment l\u2019\u00e9valuation s\u00e9quentiel de biomarqueurs et pourrait \u00eatre consid\u00e9r\u00e9 dans le <i>design<\/i> de futurs essais th\u00e9rapeutiques.<\/p>\n<p><strong>Le regard du biostatisticien<\/strong><\/p>\n<p><b>L<\/b>e plan d\u2019analyse statistique de cet essai de phase II demeure tr\u00e8s basique et classique, mais pas moins fourni sur le plan descriptif. La publication fourni des \u00e9l\u00e9ments tr\u00e8s d\u00e9taill\u00e9s et graphiques, comme une analyse mol\u00e9culaire et d\u2019\u00e9l\u00e9gants <em>Sankey plot<\/em> (sorte d\u2019histogrammes reli\u00e9s par des vagues repr\u00e9sentant la part de patients passant d\u2019une situation \u00e0 une autre). Ces r\u00e9sultats tr\u00e8s prometteurs sur les plans de la <em>safety<\/em> et de l\u2019efficacit\u00e9 m\u00e9ritent une phase III.<\/p>\n<\/div><\/div><\/div><\/div><\/div>","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":16833,"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":[],"ppma_author":[459],"class_list":["post-16689","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-revue-de-presse","author-lin-pierre-zhao"],"aioseo_notices":[],"authors":[{"term_id":459,"user_id":0,"is_guest":1,"slug":"lin-pierre-zhao","display_name":"Lin-Pierre ZHAO","avatar_url":{"url":"https:\/\/www.hematostat.net\/wp-content\/uploads\/2023\/06\/Capture-decran-2023-03-29-a-12.52.50-1.png","url2x":"https:\/\/www.hematostat.net\/wp-content\/uploads\/2023\/06\/Capture-decran-2023-03-29-a-12.52.50-1.png"},"first_name":"","last_name":"","user_url":"","description":"H\u00e9matologue. <br>\r\nChef de clinique assistant <br>\r\n<strong>Liens d'int\u00e9r\u00eats au 06\/03\/2024 : <\/strong>l'auteur d\u00e9clare ne pas avoir de liens d'int\u00e9r\u00eats. <br>\r\n<strong>Liens d'int\u00e9r\u00eats au 01\/01\/2024 : <\/strong>l'auteur d\u00e9clare ne pas avoir de liens d'int\u00e9r\u00eats. <br>\r\n<strong>Correspondance : <\/strong>Service H\u00e9matologie S\u00e9niors - Tr\u00e8fle 4 | H\u00f4pital Saint-Louis | Universit\u00e9 Paris Cit\u00e9\r\nInserm U1160 | Institut de Recherche Saint-Louis\r\n1 avenue Claude Vellefaux, 75010 Paris.<br>"}],"_links":{"self":[{"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts\/16689","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\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/comments?post=16689"}],"version-history":[{"count":4,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts\/16689\/revisions"}],"predecessor-version":[{"id":18246,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts\/16689\/revisions\/18246"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/media\/16833"}],"wp:attachment":[{"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/media?parent=16689"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/categories?post=16689"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/tags?post=16689"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/ppma_author?post=16689"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}