Tanggal 17-20 Juni 2015, Konperénsi Lymphoma Internasional ka-13 hasil diayakeun di Swiss. 3700 wawakil ti 90 nagara anu ilubiung dina acara éta. Dina rapat éta, panilitian ngeunaan limfoma cemerlang, henteu ngan ukur kasimpulan tina uji coba dikontrol multi-pusat, tapi ogé pangaruh pangaruh awal pangobatan narkoba anyar, sareng laporan hasil panilitian patogénesis, sareng sajabana, anu henteu diragukeun. diagnosis sareng diagnosis limfoma. Perlakuan salajengna nunjukkeun arah sareng nampilkeun pésta anu leueur ka klinik.
1. Limfoma folikel: titik tungtung pangobatan anu énggal
progression-free survival (PFS) is the primary endpoint of first-line treatment of follicular lymphoma, but because of the longer follow-up period (expected ≥ 7 years), there are certain limitations . The FLASH team conducted a prospective meta-analysis (abstract number: 122), and the results showed that a complete response at 30 months (CR30) may be the primary endpoint of the first-line treatment study of follicular lymphoma. The study included 13 clinical trials and a total of 3837 patients were available for evaluation. The results showed that the linear correlation coefficient of CR30 and PFS at the trial level was 0.88, and the Copula model correlation coefficient was 0.86; the risk ratio at the patient level was 0.703. In the subgroup with invasive disease (stage IV or high FLIPI score), the correlation between the two is more obvious.
2. limfoma Hodgkin urang: Perawatan dipandu jangka sedeng PET-CT
The international multi-center prospective RATHL study (abstract number: 008) included 1214 patients with newly-treated adult Hodgkin lymphoma, all of which were stage ⅡB-Ⅳ, or ⅡA combined with large masses, or ≥3 affected sites. All patients were given 2 cycles of ABVD chemotherapy followed by PET-CT (PET2). PET2 negative patients were randomly given 4 cycles of ABVD regimen or AVD regimen chemotherapy, and then entered the follow-up period. PET2-positive patients were given 4-cycle BEACOPP-14 regimen or 3-cycle enhanced BEACOPP regimen chemotherapy, and then performed PET-CT examination again (PET3); PET3-negative patients continued to receive 2-cycle BEACOPP-14 regimen or 1-cycle enhanced BEACOPP regimen chemotherapy; Patients with PET3 positive were given radiotherapy or salvage chemotherapy. Regardless of whether there is a large mass at baseline or whether there are residual lesions after treatment, if the mid-term PET-CT test is negative, no radiotherapy will be given. Results PET2 was negative in 84% of patients, with a median follow-up of 32 months, 3-year PFS was 83%, and overall survival rate (OS) was 95%. The 3-year PFS of the ABVD regimen group and the AVD regimen group were similar (85.45% and 84.48%, respectively), and the 3-year OS was not statistically different (97.0% and 97.5%, respectively), but the lung toxicity of the ABVD regimen was significantly higher than that of AVD The protocol suggests that it is safe and effective to remove bleomycin in the ABVD protocol.
3. Limfoma primér sistim saraf pusat: Titipe sareng rituximab ningkatkeun kaberhasilan
IELSG32 mangrupikeun uji coba fase II internasional multi-puseur prospektif (nomer abstrak: 009), kalebet 227 pasién sareng limfoma sistem saraf pusat pusat anu nembé dirawat, kalayan umur median 58 taun (18-70 taun). Acak dibagi kana tilu kelompok: Grup A dibéré 4 siklus MTX 3.5g / m2 (d1), Ara-C 2g / m2 (d2-3); Grup B dibéré rituximab 375mg / m2 (d -5, d0); Grup C dibéré Titipipe 30 mg / m2 (d4) dumasar kana Grup B; jalma anu épéktip sacara acak dibagi kana gugus radioterapi otak utami sareng carmustine digabungkeun sareng perlakuan Titipi dikombinasikeun sareng grup cangkok sél Stém otologis. Hasil Total tingkat épéktip tina tilu kelompok nyaéta 53%, 74%, sareng 87%, tingkat CR 23%, 31%, sareng 49%, sareng tingkat salamet bébas gagal 5 taun nyaéta 34%, 43%, sareng 54%, masing-masing. OS na masing-masing 27%, 50%, sareng 66%, nunjukkeun yén nambihan rituximab sareng titipe kana rencana pangobatan tiasa sacara signifikan ningkatkeun efficacy sareng ningkatkeun ramalan jangka panjang.
4. Perawatan sél T reséptor antimer chimeric cell (CAR-T): hasil awal
Sél CTL019 mangrupikeun sél CAR-T anu nargétkeun CD19 sareng nunjukkeun épék anti-tumor anu saé dina pasién anu lepatemia sareng relaksasi. Sidang klinis tahap II (nomer abstrak: 139) diverifikasi khasiat sél CTL019 dina pengobatan limfoma non-Hodgkin positip CD19. Panilitian kalebet 29 pasién limfoma réfrakter ulang, kalebet 19 kasus limfoma sél B anu sumebar, 8 kasus limfoma folikel, sareng 2 kasus limfoma sél mantel. Umurna rata-rata yuswa 56 taun. 1-4 dinten saatos kémoterapi, sél 5 × 108 CTL019 dibéré intravena. Hasil Total tingkat épéktip nyaéta 68%. Diantarana, tingkat CR limfoma sél B anu sumebar ageung nyaéta 42%, sareng tingkat rédisi parsial (PR) 8%; tingkat CR limfoma folikel nyaéta 57% sareng tingkat PR 43%. 15 pasién dikembangkeun sindrom pelepasan sitokin. Kalayan median tindak lanjut 6 bulan, PFS mangrupikeun 59%. Terapi sél CTL019 sél aman sareng épéktip.
5. Ganda-mogok ngalawan limfoma sél B-séhat anu sumebar: Selinexor épéktip dina vitro sareng vivo
Selinexor mangrupikeun sambetan pamilih lisan tina ékspor nuklir, ngahambat XPO1, ngamajukeun ingetan nuklir sareng aktivasina langkung ti 10 protéin suppressor tumor, sareng ngirangan tingkat protein c-myc sareng BCL2 / 6 ngalangkungan ingetan nuklir Eif4e. Dina tés in vitro (nomer abstrak: 146), Selinexor ngagaduhan pangaruh pambatesan anu hadé dina dobel-dobel sumebar garis sél limfoma B-ageung DoHH2, sareng éta ogé ngagaduhan pangaruh pambatesan anu hadé pikeun garis sél mutan MYC atanapi BCL2. Dina uji klinis Fase I, 6 pasién nampi pangobatan Selinexor, sareng 3 pasién ngahontal remisi, dimana 1 pasién dikonfirmasi ku CR dina PET-CT sareng 2 pasién nampi PR.
Sajaba ti éta, indéks prognostic leukemia lymphocytic kronis sarta lymphoma sél mantel ieu ogé dibahas sarta dianalisis dina konferensi ieu, sarta indikator patologis leuwih klinis diwanohkeun ka nangtoskeun ramalan jangka panjang; sareng Klasifikasi Limfoma Organisasi Kaséhatan Dunia 2016 Eusi anu diropéa tina édisi ogé dibere sateuacanna dina konperénsi éta. Pondokna, convening tina acara grand ieu nunjuk kaluar arah anyar pikeun diagnosis tur perlakuan lymphoma, sarta pasti bakal salajengna ngaoptimalkeun perlakuan individual dumasar kana ubar dumasar-bukti.
