Bortezomib-based chemotherapy in mantle cell lymphoma
Mené dans 28 pays sur 268 patients atteints d'un lymphome à cellules du manteau récemment diagnostiqué et inéligibles pour une greffe, cet essai de phase III compare l'efficacité, du point de vue de la survie globale, et la toxicité de deux stratégies thérapeutiques de première ligne, l'une de type VR-CAP (bortézomib, rituximab, cyclophosphamide, doxorubicine et prednisone) et l'autre de type R-CHOP (rituximab, cyclophosphamide, doxorubicine, vincristine et prednisone) (durée médiane de suivi : 82 mois)
Management of patients with newly diagnosed mantle cell lymphoma is fairly well established. For younger patients, treatment involves high-dose cytarabine-based chemotherapy, which is usually consolidated with stem-cell transplantation and rituximab maintenance therapy. For older patients, in whom high-intensity therapy is inappropriate, immuno-chemotherapy is the treatment of choice, and is usually based on either CHOP-based (cyclophosphamide, doxorubicin, vincristine, and prednisone) or bendamustine-based therapies. Because the average age at presentation for mantle cell lymphoma is around 70 years, most patients fall within the latter group. Very few randomised trials have been done in mantle cell lymphoma, and therefore data to inform best practice are scarce. Furthermore, the trials that have been done were subset analyses of larger trials or often underpowered.
The Lancet Oncology , commentaire, 2017