Blood:来那度胺联合利妥昔单抗作为套细胞淋巴瘤的初始治疗,缓解率高且持久

2018-09-06 MedSci MedSci原创

中心点:来那度胺联合利妥昔单抗作为MCL的诱导和维持疗法可获得持久的MRD阴性的完全缓解。长期治疗相关的不良事件通常是非累积性的,且仍可控。摘要:研究人员开展了一多中心的2期试验,招募了38位未治疗过的MCL患者,中位年龄65岁,套细胞淋巴瘤国际预后指数(MIPI)评分分布在低、中、高风险(分别占34%、34%和32%),予以来那度胺联合利妥昔单抗(LR)作为初始治疗,包括诱导和维持。治疗持续至病

中心点:

来那度胺联合利妥昔单抗作为MCL的诱导和维持疗法可获得持久的MRD阴性的完全缓解。

长期治疗相关的不良事件通常是非累积性的,且仍可控。

摘要:

研究人员开展了一多中心的2期试验,招募了38位未治疗过的MCL患者,中位年龄65岁,套细胞淋巴瘤国际预后指数(MIPI)评分分布在低、中、高风险(分别占34%、34%和32%),予以来那度胺联合利妥昔单抗(LR)作为初始治疗,包括诱导和维持。治疗持续至病情进展或3年后患者选择终止。

27位(75%)患者完成了至少3年的治疗研究。中位随访64个月(21-78)时,3年无进展存活率(PFS)和总体存活率(OS)分别是80%和90%,5年PFS和OS分别是64%和77%。

在维持期间,血液学AEs包括无症状的3-4级血细胞减少(中性粒细胞减少 42%、血小板减少 5%、贫血 3%),门诊患者多见1-2级感染(上呼吸道感染[URI]45%、泌尿道感染[UTI] 21%、鼻窦炎 13%、蜂窝织炎 11%和肺炎 8%)。非血液学AEs,如体质和炎症症状,发生频率和严重程度均低于诱导时的。

在10位完成至少3年治疗的患者中,有8位患者的外周血液MRD试验显示为MRD阴性CR。随着随访时间的延长,LR作为MCL的初始诱导和维持治疗,继续表现出持久的缓解和可管理的安全性。

原始出处:

Jia Ruan, Peter Martin, et al. Five-year follow-up of lenalidomide plus rituximab as initial treatment for mantle cell lymphoma. Blood  2018  :blood-2018-07-859769;  doi: https://doi.org/10.1182/blood-2018-07-859769

本文系梅斯医学(MedSci)原创编译,转载需授权!

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=2022116, encodeId=79c820221168d, content=<a href='/topic/show?id=0ca732196ef' target=_blank style='color:#2F92EE;'>#初始治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32196, encryptionId=0ca732196ef, topicName=初始治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f7482500171, createdName=ms4468361851264128, createdTime=Thu Dec 20 17:25:00 CST 2018, time=2018-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1660443, encodeId=f671166044396, content=<a href='/topic/show?id=c0de32285a1' target=_blank style='color:#2F92EE;'>#利妥昔#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32285, encryptionId=c0de32285a1, topicName=利妥昔)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a58d25117340, createdName=花花1374, createdTime=Tue Mar 26 08:25:00 CST 2019, time=2019-03-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1702515, encodeId=cf5d1e0251585, content=<a href='/topic/show?id=ddc9e795159' target=_blank style='color:#2F92EE;'>#细胞淋巴瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77951, encryptionId=ddc9e795159, topicName=细胞淋巴瘤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=201630414353, createdName=marlenexl, createdTime=Wed Jun 12 07:25:00 CST 2019, time=2019-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=348777, encodeId=cc3e348e7732, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2018/10/10/17994776f680c9f4e7b8b44302cc2dcf.jpg, createdBy=c8632443737, createdName=想快快成长的医学小白, createdTime=Wed Oct 10 15:36:17 CST 2018, time=2018-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=343240, encodeId=66f3343240dd, content=好文,值得点赞!认真学习,应用于实践!谢谢分享给广大同好!, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Thu Sep 06 09:43:14 CST 2018, time=2018-09-06, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=2022116, encodeId=79c820221168d, content=<a href='/topic/show?id=0ca732196ef' target=_blank style='color:#2F92EE;'>#初始治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32196, encryptionId=0ca732196ef, topicName=初始治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f7482500171, createdName=ms4468361851264128, createdTime=Thu Dec 20 17:25:00 CST 2018, time=2018-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1660443, encodeId=f671166044396, content=<a href='/topic/show?id=c0de32285a1' target=_blank style='color:#2F92EE;'>#利妥昔#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32285, encryptionId=c0de32285a1, topicName=利妥昔)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a58d25117340, createdName=花花1374, createdTime=Tue Mar 26 08:25:00 CST 2019, time=2019-03-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1702515, encodeId=cf5d1e0251585, content=<a href='/topic/show?id=ddc9e795159' target=_blank style='color:#2F92EE;'>#细胞淋巴瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77951, encryptionId=ddc9e795159, topicName=细胞淋巴瘤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=201630414353, createdName=marlenexl, createdTime=Wed Jun 12 07:25:00 CST 2019, time=2019-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=348777, encodeId=cc3e348e7732, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2018/10/10/17994776f680c9f4e7b8b44302cc2dcf.jpg, createdBy=c8632443737, createdName=想快快成长的医学小白, createdTime=Wed Oct 10 15:36:17 CST 2018, time=2018-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=343240, encodeId=66f3343240dd, content=好文,值得点赞!认真学习,应用于实践!谢谢分享给广大同好!, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Thu Sep 06 09:43:14 CST 2018, time=2018-09-06, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=2022116, encodeId=79c820221168d, content=<a href='/topic/show?id=0ca732196ef' target=_blank style='color:#2F92EE;'>#初始治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32196, encryptionId=0ca732196ef, topicName=初始治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f7482500171, createdName=ms4468361851264128, createdTime=Thu Dec 20 17:25:00 CST 2018, time=2018-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1660443, encodeId=f671166044396, content=<a href='/topic/show?id=c0de32285a1' target=_blank style='color:#2F92EE;'>#利妥昔#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32285, encryptionId=c0de32285a1, topicName=利妥昔)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a58d25117340, createdName=花花1374, createdTime=Tue Mar 26 08:25:00 CST 2019, time=2019-03-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1702515, encodeId=cf5d1e0251585, content=<a href='/topic/show?id=ddc9e795159' target=_blank style='color:#2F92EE;'>#细胞淋巴瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77951, encryptionId=ddc9e795159, topicName=细胞淋巴瘤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=201630414353, createdName=marlenexl, createdTime=Wed Jun 12 07:25:00 CST 2019, time=2019-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=348777, encodeId=cc3e348e7732, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2018/10/10/17994776f680c9f4e7b8b44302cc2dcf.jpg, createdBy=c8632443737, createdName=想快快成长的医学小白, createdTime=Wed Oct 10 15:36:17 CST 2018, time=2018-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=343240, encodeId=66f3343240dd, content=好文,值得点赞!认真学习,应用于实践!谢谢分享给广大同好!, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Thu Sep 06 09:43:14 CST 2018, time=2018-09-06, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=2022116, encodeId=79c820221168d, content=<a href='/topic/show?id=0ca732196ef' target=_blank style='color:#2F92EE;'>#初始治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32196, encryptionId=0ca732196ef, topicName=初始治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f7482500171, createdName=ms4468361851264128, createdTime=Thu Dec 20 17:25:00 CST 2018, time=2018-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1660443, encodeId=f671166044396, content=<a href='/topic/show?id=c0de32285a1' target=_blank style='color:#2F92EE;'>#利妥昔#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32285, encryptionId=c0de32285a1, topicName=利妥昔)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a58d25117340, createdName=花花1374, createdTime=Tue Mar 26 08:25:00 CST 2019, time=2019-03-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1702515, encodeId=cf5d1e0251585, content=<a href='/topic/show?id=ddc9e795159' target=_blank style='color:#2F92EE;'>#细胞淋巴瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77951, encryptionId=ddc9e795159, topicName=细胞淋巴瘤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=201630414353, createdName=marlenexl, createdTime=Wed Jun 12 07:25:00 CST 2019, time=2019-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=348777, encodeId=cc3e348e7732, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2018/10/10/17994776f680c9f4e7b8b44302cc2dcf.jpg, createdBy=c8632443737, createdName=想快快成长的医学小白, createdTime=Wed Oct 10 15:36:17 CST 2018, time=2018-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=343240, encodeId=66f3343240dd, content=好文,值得点赞!认真学习,应用于实践!谢谢分享给广大同好!, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Thu Sep 06 09:43:14 CST 2018, time=2018-09-06, status=1, ipAttribution=)]
    2018-10-10 想快快成长的医学小白

    学习了

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=2022116, encodeId=79c820221168d, content=<a href='/topic/show?id=0ca732196ef' target=_blank style='color:#2F92EE;'>#初始治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32196, encryptionId=0ca732196ef, topicName=初始治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f7482500171, createdName=ms4468361851264128, createdTime=Thu Dec 20 17:25:00 CST 2018, time=2018-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1660443, encodeId=f671166044396, content=<a href='/topic/show?id=c0de32285a1' target=_blank style='color:#2F92EE;'>#利妥昔#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32285, encryptionId=c0de32285a1, topicName=利妥昔)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a58d25117340, createdName=花花1374, createdTime=Tue Mar 26 08:25:00 CST 2019, time=2019-03-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1702515, encodeId=cf5d1e0251585, content=<a href='/topic/show?id=ddc9e795159' target=_blank style='color:#2F92EE;'>#细胞淋巴瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77951, encryptionId=ddc9e795159, topicName=细胞淋巴瘤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=201630414353, createdName=marlenexl, createdTime=Wed Jun 12 07:25:00 CST 2019, time=2019-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=348777, encodeId=cc3e348e7732, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2018/10/10/17994776f680c9f4e7b8b44302cc2dcf.jpg, createdBy=c8632443737, createdName=想快快成长的医学小白, createdTime=Wed Oct 10 15:36:17 CST 2018, time=2018-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=343240, encodeId=66f3343240dd, content=好文,值得点赞!认真学习,应用于实践!谢谢分享给广大同好!, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Thu Sep 06 09:43:14 CST 2018, time=2018-09-06, status=1, ipAttribution=)]
    2018-09-06 ylzr123

    好文,值得点赞!认真学习,应用于实践!谢谢分享给广大同好!

    0

相关资讯

2018 BSH指南:套细胞淋巴瘤的管理

2018年5月,英国血液病学学会(BSH)发布了套细胞淋巴瘤的管理指南,指南主要目的是面向临床医生针对套细胞淋巴瘤患者的管理提出指导建议,该指南是对2012年指南的更新,新版指南涵盖了套细胞淋巴瘤的新的治疗观点,涉及移植数据,病理学进展尤其是分子病理学和PET/CT在肿瘤分期和治疗反应评估中的应用。

Blood:套细胞淋巴瘤

套细胞淋巴瘤(MCL)是一种罕见的非霍奇金淋巴瘤亚型,鉴于其预后不良,确诊时常采用化疗免疫联合疗法。现已发现其更多的惰性特点,如患者推迟初始治疗而不影响存活期。2016年世界卫生组织更新的分类描述了两种主要亚型,典型MCL和白血病性非淋巴结性MCL,各有其独特的分子特征和临床表现。目前尚无MCL的标准疗法,以利妥昔单抗和阿糖胞苷为主的强效化疗免疫方案,联合自体干细胞移植进行巩固、利妥昔单抗维持是年

Lancet:acalabrutinib用于治疗复发性/难治性套细胞淋巴瘤的效果和安全性。

Bruton酪氨酸激酶是一种经过评估临床验证的套细胞淋巴瘤的治疗靶点。Acalabrutinib(ACP-196)是高选择性的、Bruton酪氨酸激酶强效抑制剂。Michael Wang等人进行一非盲的2期研究,评估acalabrutinib用于复发性/难治性套细胞淋巴瘤患者的治疗效果和安全性。研究人员招募复发性/难治性套细胞淋巴瘤患者,予以口服acalabrutinib(100mg 2次/日),

Blood:TP53高表达,可用于预测MCL患者预后不良。

目前,预测套细胞淋巴瘤治疗失败和总体存活时间是基于临床因素,包含套细胞淋巴瘤国际预后指数(MIPI)和根据Ki67评估的增殖情况。然而,P53和SOX11的免疫组化也可提高风险分层。Sietse M.Aukema等人在目前最新发表的淋巴瘤样本(365例)中行免疫组化检测SOX11和P53。所有患者都接受了欧洲MCL网络的前瞻性试验。在包含了MIPI和Ki67的多变量分析中,SOX11表达与患者治疗

蔡清清教授:套细胞淋巴瘤治疗新进展综述

套细胞淋巴瘤(MCL)是起源于淋巴结套区的一种罕见B细胞淋巴瘤亚型,以t(11;14)(q13; q32)染色体异常及Cyclin D1过表达为其独特的分子生物学特征。MCL多见于中老年人,临床病程多呈侵袭性,且预后差。目前,对于年轻MCL 患者治疗均推荐含大剂量阿糖胞苷(HD-Ara-c)的诱导方案联合自体造血干细胞移植(ASCT),而对于老年患者或不能进行 ASCT 的患者则推荐利妥昔单抗联合

Blood:SOX11可放大BCR信号,促进MCL样肿瘤细胞进展

中心点:B细胞特异性过表达SOX11可促进B1a B细胞致瘤性增殖,并驱动出现MCL样表型。SOX11过表达与通过BCR信号增强的信号通路相关,BCR信号可被药物BTK抑制剂逆转。摘要:套细胞(MCL)的特点是B细胞受体(BCR)信号增强,应用BTK抑制剂治疗MCL患者可获得积极的治疗效果。但对导致MCL发生BCL信号增强的潜在机制尚不明了,尤其是在其他的淋巴瘤中,BCR信号上游调控子(如CD79