Clin Cancer Res:利妥昔单抗+来那度胺→来那度胺治疗惰性非霍奇金淋巴瘤的长期预后

2021-09-09 Nebula MedSci原创

利妥昔单抗联合来那度胺继以来那度胺维持可有效治疗惰性非霍奇金淋巴瘤

利妥昔单抗和来那度胺对既往未治疗过的复发性/难治性 (R/R) 惰性非霍奇金淋巴瘤 (iNHL) 有效。但是,iNHL 的长期预后和预后预测生物标志物均尚不明确。

Tuscano 等研究人员进行了两项开放标签的 II 期试验,纳入了 60 位既往未治疗过的和 R/R 晚期 iNHL 患者。患者接受来那度胺和利妥昔单抗诱导后,继续接受来那度胺治疗,直到疾病进展或出现不可接受的毒性。主要终点是总缓解率(ORR)。相关研究包括血浆细胞因子监测、外周血单个核细胞的流式细胞术(PBMC;第 0、15、30 和 60 天)和治疗前肿瘤活检组织的 RNA 测序。

未治疗过的队列(A)和 R/R 队列(B)患者的PFS和OS

既往未治疗过的晚期 iNHL 患者和 R/R 晚期 iNHL 患者的中位随访时间分别是 63 个月和 100 个月;两组患者的 ORR 都是 82%。11 位获得完全缓解的 R/R iNHL 患者的缓解持续时间在 16-141 个月。截止分析日期时,未治疗过的患者组的中位总生存期(OS)尚未达到,R/R 组患者的为 140 个月(95%CI 53.4-140)

通过混合效应的线性回归模型发现, Granzyme B+(GranB+)CD8+ T细胞和长期完全缓解(LTCR)之间存在显著相关性(p<0.0001)。此外,治疗前的 B 细胞和 GranB+CD8+ T 细胞水平可预测治疗反应性。

综上,对于既往未治疗过的和 R/R iNHL 患者,利妥昔单抗联合来那度胺继以来那度胺维持治疗是有效的,而且毒性可控。该方案可使患者获得持久的缓解,即使是是重度预处理的患者,部分患者的持续缓解时间甚至超过了10年。GranB+CD8+ T细胞、B 细胞和血浆 IFNγ 水平可预测长期完全缓解率,但需要进一步验证。

原始出处:

Joseph M. Tuscano, et al. Long-term Follow-up and Correlative Analysis of Two Phase II Trials of Rituximab and Lenalidomide Followed by Continuous Lenalidomide in Untreated and Relapsed/Refractory Indolent Lymphoma. Clin Cancer Res September 1 2021 27 (17) 4726-4736; DOI:10.1158/1078-0432.CCR-20-4622

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    2021-09-09 lotus~

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    #肿瘤#积分

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