{"id":16957,"date":"2023-07-04T13:02:48","date_gmt":"2023-07-04T11:02:48","guid":{"rendered":"https:\/\/www.hematostat.net\/?p=16957"},"modified":"2024-12-11T19:05:35","modified_gmt":"2024-12-11T18:05:35","slug":"venetoclax-ven-en-premiere-ligne-dans-la-leucemie-lymphoide-chronique-llc","status":"publish","type":"post","link":"https:\/\/www.hematostat.net\/en\/venetoclax-ven-en-premiere-ligne-dans-la-leucemie-lymphoide-chronique-llc\/","title":{"rendered":"V\u00e9n\u00e9toclax (VEN) en premi\u00e8re ligne dans la leuc\u00e9mie lympho\u00efde chronique (LLC)"},"content":{"rendered":"

R\u00e9f. : HematoStat.net ; 4 (2) : R79<\/p>\n

<\/em>Eichhorst B, Niemann CU, Kater AP, et al. First-Line Venetoclax Combinations in Chronic Lymphocytic Leukemia. <\/em>N Engl J Med<\/em>. 2023 11;388(19):1739-1754.<\/em><\/a><\/em><\/p>\n

<\/em>R\u00e9sum\u00e9 de l\u2019article<\/strong><\/p>\n

Cette \u00e9tude de phase 3 a randomis\u00e9 4 groupes de traitements chez des patients fit atteints de LLC, incluant l\u2019immunochimioth\u00e9rapie (n=229, fludarabine-endoxan ou bendamustine + rituximab, R), VEN-R (n=237), VEN-obinutuzumab (VEN-OBI) (n=229) ou VEN-ibrutinib-obinutuzumab (VEN-OBI-IBRU) (n=231). \u00c0 15 mois, les taux de MRD n\u00e9gatifs \u00e9taient sup\u00e9rieurs dans les groupes VEN-OBI-IBRU (92 %) et VEN-OBI (87 %) en comparaison du groupe immunochimioth\u00e9rapie (52 %) et du groupe VEN-R (57 %). La survie sans progression (PFS) \u00e0 3 ans \u00e9tait \u00e9galement meilleure dans les groupes VEN-OBI-IBRU (91 %) et VEN-OBI (88 %) en comparaison des groupes immunochimioth\u00e9rapie (76 %) et VEN-R (81 %).<\/p>\n

Dans nos pratiques<\/strong><\/p>\n

On retiendra de nombreux points int\u00e9ressants dans cette phase 3 : i\/ la sup\u00e9riorit\u00e9 du VEN en premi\u00e8re ligne contre l\u2019immunochimioth\u00e9rapie chez les patients LLC fit<\/i> ; ii\/ l\u2019OBI qui semble \u00eatre un partenaire anti-CD20 plus efficace que le R en combinaison avec le v\u00e9n\u00e9toclax et iii\/ l\u2019utilisation de la MRD (cytom\u00e9trie de flux) comme crit\u00e8re de jugement principal, qui pourrait \u00eatre un substitut \u00e0 la PFS.<\/p>\n

Le regard du biostatisticien<\/strong><\/p>\n

Cet essai clinique de phase 3 a la particularit\u00e9 d\u2019avoir quatre bras de randomisation, n\u00e9cessitant un calcul d\u2019effectif un peu plus complexe que d\u2019habitude et d\u2019imposer des seuils de significativit\u00e9 plus bas (2.5 % au lieu de 5 % pour pallier la probl\u00e9matique des tests multiples). C\u2019est une \u00e9tude open-label<\/em> mais les r\u00e9sultats sont tr\u00e8s parlants aux vues des crit\u00e8res principaux et secondaires.<\/p>\n<\/div><\/div><\/div><\/div><\/div>","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":16958,"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-16957","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.
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