NEJM:来那度胺+利妥昔单抗用于未经治疗的晚期滤泡性淋巴瘤

2018-09-11 zhangfan MedSci原创

研究认为来那度胺联合利妥昔单抗的免疫疗法对未经治疗的晚期滤泡性淋巴瘤患者的疗效与现行标准疗法相当

利妥昔单抗联合化疗是未经治疗的晚期滤泡性淋巴瘤患者的一线治疗手段,但大多数患者复发风险较高。先前研究发现,来那度胺联合利妥昔单抗的免疫疗法对低度恶性B细胞非霍奇金淋巴瘤患者具有积极的治疗效果。近日研究人员开展III期研究,考察了来那度胺联合利妥昔单抗对未经治疗的晚期滤泡性淋巴瘤患者的疗效。

符合条件的患者随机接受利妥昔单抗联合化疗或来那度胺联合利妥昔单抗治疗,随后接受利妥昔单抗维持治疗。来那度胺联合利妥昔单抗组患者先接受18轮的联合治疗,随后每8周接受总计12轮的维持治疗。利妥昔单抗联合化疗患者接受3种利妥昔单抗为基础的治疗方案,随后每8周接受总计12轮的维持治疗。研究的主要终点为120周完全响应率以及无进展生存率。

1030名患者参与研究,其中来那度胺联合利妥昔单抗组513人,利妥昔单抗联合化疗组517人。组间120周治疗完全响应率以及3年无进展生存率相近,来那度胺联合利妥昔单抗组分别为48%和77%,利妥昔单抗联合化疗组为53%和78%。化疗组3-4级嗜中性白血球减少症(32% vs 50%)以及发热性中性粒细胞减少(2% vs 7%)的发病率较高,而来那度胺组3-4级皮内变态反应率较高(7% vs. 1%)。

研究认为来那度胺联合利妥昔单抗的免疫疗法对未经治疗的晚期滤泡性淋巴瘤患者的疗效与现行标准疗法相当。

原始出处:

Franck Morschhauseret al. Rituximab plus Lenalidomide in Advanced Untreated Follicular Lymphoma. N Engl J Med,September 6,2018.

本文系梅斯医学(MedSci)原创编译整理,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 (4)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1660444, encodeId=bb0b1660444a7, 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=35, 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 Oct 09 04:36:00 CST 2018, time=2018-10-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=348776, encodeId=bd1d348e76a3, content=学习了,很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, 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 15:23:09 CST 2018, time=2018-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1278784, encodeId=cd6212e8784cc, content=<a href='/topic/show?id=5bd36658e94' target=_blank style='color:#2F92EE;'>#滤泡性淋巴瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66587, encryptionId=5bd36658e94, topicName=滤泡性淋巴瘤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1a5a149, createdName=gongliu, createdTime=Thu Sep 13 02:36:00 CST 2018, time=2018-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=344516, encodeId=494934451692, content=谢谢分享,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Tue Sep 11 12:37:27 CST 2018, time=2018-09-11, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1660444, encodeId=bb0b1660444a7, 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=35, 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 Oct 09 04:36:00 CST 2018, time=2018-10-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=348776, encodeId=bd1d348e76a3, content=学习了,很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, 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 15:23:09 CST 2018, time=2018-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1278784, encodeId=cd6212e8784cc, content=<a href='/topic/show?id=5bd36658e94' target=_blank style='color:#2F92EE;'>#滤泡性淋巴瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66587, encryptionId=5bd36658e94, topicName=滤泡性淋巴瘤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1a5a149, createdName=gongliu, createdTime=Thu Sep 13 02:36:00 CST 2018, time=2018-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=344516, encodeId=494934451692, content=谢谢分享,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Tue Sep 11 12:37:27 CST 2018, time=2018-09-11, status=1, ipAttribution=)]
    2018-10-10 想快快成长的医学小白

    学习了,很好

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1660444, encodeId=bb0b1660444a7, 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=35, 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 Oct 09 04:36:00 CST 2018, time=2018-10-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=348776, encodeId=bd1d348e76a3, content=学习了,很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, 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 15:23:09 CST 2018, time=2018-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1278784, encodeId=cd6212e8784cc, content=<a href='/topic/show?id=5bd36658e94' target=_blank style='color:#2F92EE;'>#滤泡性淋巴瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66587, encryptionId=5bd36658e94, topicName=滤泡性淋巴瘤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1a5a149, createdName=gongliu, createdTime=Thu Sep 13 02:36:00 CST 2018, time=2018-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=344516, encodeId=494934451692, content=谢谢分享,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Tue Sep 11 12:37:27 CST 2018, time=2018-09-11, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=1660444, encodeId=bb0b1660444a7, 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=35, 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 Oct 09 04:36:00 CST 2018, time=2018-10-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=348776, encodeId=bd1d348e76a3, content=学习了,很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, 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 15:23:09 CST 2018, time=2018-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1278784, encodeId=cd6212e8784cc, content=<a href='/topic/show?id=5bd36658e94' target=_blank style='color:#2F92EE;'>#滤泡性淋巴瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66587, encryptionId=5bd36658e94, topicName=滤泡性淋巴瘤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1a5a149, createdName=gongliu, createdTime=Thu Sep 13 02:36:00 CST 2018, time=2018-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=344516, encodeId=494934451692, content=谢谢分享,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Tue Sep 11 12:37:27 CST 2018, time=2018-09-11, status=1, ipAttribution=)]
    2018-09-11 明月清辉

    谢谢分享,学习了

    0

相关资讯

CLIN CANCER RES:滤泡性淋巴瘤中表达TIGIT的T细胞增多

滤泡性淋巴瘤中浸润的T细胞通常存在功能失调,但是理想的免疫检查点阻断靶点尚未知。分析滤泡性淋巴瘤T细胞亚群共抑制受体表达模式及信号反应可能会有助于发现新的治疗靶点。CLIN CANCER RES近期发表了一篇文章对这一问题进行研究。

Lancet Oncol:基因表达谱数据再建新功:精准判断部分滤泡性淋巴瘤患者的预后

滤泡性淋巴瘤(FL)预后高度不一致,部分患者会出现早期复发,甚至转化为高级别淋巴瘤。因此,临床需要在确诊时即根据相关预测模型确定患者的进展风险。法国里昂癌症研究中心Huet等利用FL基因表达谱数据构建了一个预后预测模型,并在利妥昔单抗治疗患者中进行了验证。

Blood:结合初始和诱导后PET,建立更为准确的预测滤泡性淋巴瘤患者预后的模型

根据基线PET计算的总代谢肿瘤体积(TMTV)和诱导结束后的PET(EOI PET)均是成像生物标志物,可提示高肿瘤负荷的滤泡性淋巴瘤患者早期危险分层的前景。近日,Blood上发表一篇文献,Anne Ségolène Cottereau等人结合来159位患者(源于3个前瞻性试验)的这两个数据,建立了一相关模型。对于这159位患者,中位随访64个月。高TMTV(>510cm3)和EOI PET

Blood:十二指肠型滤泡性淋巴瘤

中心点:DTFL的免疫图谱与淋巴结型FL高度相关,但携带较少的KMT2D多发/等位基因突变。DTFL的免疫微环境与淋巴结型FL的显着不同,富集慢性炎症基因特征。摘要:十二指肠型滤泡性淋巴瘤(DTFL)是一种罕见的高度惰性的滤泡性淋巴瘤(FL)。其形态学和免疫表型与典型FL无明显区别,其特征是小肠黏膜限制性受损,无肠外表现。目前,造成其临床特征如此独特的分子机制基本尚不明确。Johannes C.

Lancet haemat:利妥昔单抗可显著降低滤泡性淋巴瘤向侵袭性淋巴瘤转化的风险

滤泡性淋巴瘤向侵袭性淋巴瘤转化,会严重影响患者预后。研究人员开展Aristotle研究对应用利妥昔单抗对组织学类型转化的风险及其预后的影响进行评估。本研究数据来源于欧洲的11个合作单位。研究对象为1997年1月2日-2013年12月20日期间经组织学确诊的年满18岁的滤泡性淋巴瘤(1期、2期或3a期)患者。组织学转化定义:一线化疗后活检发现侵袭性淋巴瘤。主要评估节点:组织学转化的累积风险和转化后的

Lancet haemat:Voxtalisib(XL765)用于滤泡性淋巴瘤患者可获得良好的治疗效果

复发性/难治性淋巴瘤或慢性淋巴系白血病患者预后差。靶向多种类型的PI3K(如mTOR)的治疗方式或可增强抗肿瘤活性。现有研究人员对voxtalisib(XL765或SAR245409)——一种fan-PI3K/mTOR抑制剂——用于复发性/难治性淋巴瘤或慢性淋巴细胞白血病/小淋巴细胞白血病患者的疗效和安全性进行评估。研究人员在多个国家的30个肿瘤诊所进行一非随机的开放性临床2期试验,招募年满18岁