Personalised approach in follicular lymphoma
Menée à partir des données d'un essai clinique de phase III incluant 1 202 patients atteints d'un lymphome folliculaire CD20+ et recevant une immunochimiothérapie de première ligne, cette étude évalue, par rapport à une tomographie numérique avec rehaussement de contraste, l'intérêt d'une tomographie numérique à émission de positrons après un traitement d'induction pour établir un pronostic
Follicular lymphoma is the most common subtype of indolent B-cell lymphoma, and patient outcomes are highly heterogeneous, with 20–30% of patients having aggressive (rather than indolent) disease. 1
These high-risk patients would benefit from a personalised approach to their care if validated and accurate prognostic tools were available to identify them as soon as possible after diagnosis. Although many prognostic tools and indices to predict survival in follicular lymphoma have been developed in the past 20 years, none of them have yet proven useful in therapeutic decision making. 1
The many reasons explaining the gap between prognostic and therapeutic research in follicular lymphoma include the relatively low accuracy of published scores, with high frequency of false positives and negatives, their poor ability to predict overall survival, the time lag before relevant prognostic information is available (eg, the use of disease progression within 24 months as a prognostic indicator), technical difficulties in the index calculation, and the stability of the prognostic score or index under the conditions of different treatment regimens (eg, R-CHOP [rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone or prednisolone], rituximab plus bendamustine, and R-CVP [rituximab plus cyclophosphamide, vincristine, and prednisone]) or maintenance therapy with anti-CD20 monoclonal antibodies.
The Lancet Oncology , commentaire, 2017