Clin Cancer Res:来那度胺联合R-GDP治疗复发/难治性弥漫性大B细胞淋巴瘤

2022-06-23 MedSci原创 MedSci原创

R2-GDP方案在R/R型DLBCL患者(包括原发难治性患者)中是可行的,且治疗活性高

不适合自体干细胞移植(ASCT)的复发性或难治性弥漫性大B细胞淋巴瘤(R/R DLBCL)患者的预后极差,亟需新的治疗方法。SCHOLAR-1研究展现了这类患者(特别是既往疗法难治性的患者)的较差临床预后,中位总生存期(OS)6.3个月,2年OS率 20%,对后续治疗的总缓解率(ORR)26%,完全缓解率只有7%。

以来那度胺为基础的治疗方案或可逆转淋巴瘤对利妥昔单抗的耐药性。在2期的R2-GDP试验中,78位不适合ASCT的淋巴瘤患者接受了R2-GDP方案治疗:来那度胺 10mg(d1-14)、利妥昔单抗 375mg/m2(d1)、顺铂 60mg/m2(d1)、吉西他滨 750mg/m2(d1和d8)和地塞米松 20mg(d1-3),长达6个疗程(诱导期),继以来那度胺 10mg(d1-21)维持治疗(维持期),28天/疗程。主要终点是总缓解率(ORR)。次要终点包括无进展生存期(PFS)、总生存期(OS)、安全性和循环生物标志物监测。


总生存率

中位随访了37个月后,ORR为60.2%,包括37.1%的完全缓解(CR)和23.1%的部分缓解(PR)。中位OS是12个月,获得完全缓解和部分缓解的患者的OS分别是47个月和6个月,中位PFS是9个月,获得完全缓解和部分缓解的患者的PFS分别是34个月和5个月。在原发难治性患者中,ORR是45.5%(21.2% CR 和24.3% PR)。


无进展生存率

最常见的3-4级不良事件有血小板减少症(60.2%)、中性粒细胞减少症(60.2%)、贫血(26.9%)、感染(15.3%)和发热性中性粒细胞减少症(14.1%)。低循环髓系衍生抑制细胞、Treg和抑制T细胞水平以及高激活T细胞水平均与更好的治疗反应和OS相关。

综上,R2-GDP方案在R/R型DLBCL患者(包括原发难治性患者)中是可行的,且治疗活性高

 

原始出处:

Natalia Palazon-Carrion, et al. Lenalidomide plus R-GDP (R2-GDP) in Relapsed/Refractory Diffuse Large B Cell Lymphoma. Final Results of the R2-GDP-GOTEL Trial and Immune Biomarker subanalysis. Clin Cancer Res clincanres.0588.2022-2-21 11:01:45.430.

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    2022-10-18 freve
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    2022-06-24 freve
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    2022-06-23 ms5000000043316693

    值得学习

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