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套细胞淋巴瘤治疗进展

作者:肿瘤瞭望   日期:2016/8/10 15:24:35  浏览量:24850

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编者按:近日,欧洲套细胞淋巴瘤(MCL)网络完成的一项II期临床研究表明,放射免疫疗法90Y-IT对于难治/复发的MCL患者有效、且具有良好的耐受性。然而,在另一研究中则显示小分子BTK抑制剂依鲁替尼治疗MCL的作用远超过90Y-IT。在不久前结束的2016欧洲血液学协会(EHA)年会上,本刊特邀请意大利都灵大学M Ladetto教授进行了专访,分享了他关于MCL治疗进展的独到见解。现将其内容整理成文,以飨读者。

意大利都灵大学M Ladetto教授访谈

 
《肿瘤瞭望》:您认为放射免疫疗法90Y-IT在MCL的全程治疗中是否能有一席之地,尤其在如今的新药时代?
 
  Ladetto教授: 90Y-IT是一种有效的治疗方法,大部分MCL患者对其治疗有反应。然而目前接受此种治疗的MCL患者较少,而是更多地选择生物制剂或生物制剂与化疗的联合治疗。目前利妥昔单抗仍是MCL治疗的基础,其它生物制剂的联合治疗多用于复发患者。总体说来,90Y-IT仍是一种有价值的治疗策略,尽管可能应用并不十分广泛。
 
  Dr. Ladetto: 90Y-ITis absolutely an effective treatment. It can provide good proportional responses; however, I believe that most of the patients with mantle cell lymphoma in the future will not undergo this kind of treatment, but will be more frequently treated with biological agents or combinations of chemotherapy and biological agents. I believe that rituximab will be the backbone of any treatments and the additional combination could be potentially usedmaybe at relapse, maybe in other situations. But I still believe that therapy will remain a useful, though not a widely employed, strategy.
 
《肿瘤瞭望》:请您谈谈有关SOX11的进展?
 
  Ladetto教授:SOX11是MCL很重要的生物学标志物。如果SOX11为阴性,预示为惰性套细胞淋巴瘤。我们应该发展MCL新的预测模型,既包括临床预测因素也包括生物学预测因素,如SOX11,用于鉴定惰性MCL患者。
 
  Dr. Ladetto: SOX11 is an important biomarker that, when it’s negative, can be predictive of indolent mantle cell lymphoma. Based on this, I believe that there should be an integrating to identify the indolent mantle cell lymphoma patient that includes both clinical and biological predictors such as the SOX11, but also the clinical presentation and the presence—or absence—of another disease like splenomegaly and lymphocytosis.
 
《肿瘤瞭望》:您在临床中怎样处理惰性MCL患者?
 
  Ladetto教授:对于惰性MCL患者我们会采取等待方法,一旦病情进展,就按照MCL的常规治疗。
 
  Dr. Ladetto: We do watch their weight whenever possible. If the patient then progresses, we treat it as a regular mantle cell lymphoma patient. Upon progression.
 
《肿瘤瞭望》: 2016WHO淋巴组织肿瘤更新中提出了“原位套细胞肿瘤”这个概念,您能谈谈它的意义何在?
 
  Ladetto教授: 鉴别原位套细胞淋巴瘤很重要,它是相对良性的疾病特征,与此同时筛选出对于MCL患者最有效的治疗也同样重要,目前尚不清楚最终结果如何。不过,原位套细胞淋巴瘤的分类与鉴别对与该领域的发展非常关键。
 
  Dr. Ladetto: Of course, the recognition of in situ mantel cell lymphoma is very important. However, it would be very important to identify which could be the most useful strategies for the patient. Currently, we do not know very well which would be the final outcome; however, the possibility of recognizing in situ mantle cell lymphoma is very critical for any future development in this field.

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