编者按:2016年8月19~21日,第二届肿瘤转化医学国际研讨会暨第一届天津国际淋巴瘤高峰论坛在天津成功召开。大会荣幸地邀请到美国临床肿瘤学会(ASCO)主席兼美国内布拉斯加医学中心淋巴血液科主任Julie Vose教授与会,并做了关于外周T细胞淋巴瘤(PTCL)治疗进展的专题学术报告。会后,本刊特邀Vose教授进行了深度访谈。现将内容整理成文,以飨读者。
美国内布拉斯加大学医学中心Julie Vose教授
《肿瘤瞭望》:外周T细胞淋巴瘤(PTCL)一线治疗研究?
Vose教授:既往PTCL的常规一线治疗方案即为CHOP方案。然而近年来我们看到很多新的临床试验在CHOP的基础上应用了新型的药物。目前报道的最好的临床实验数据是在诱导化疗的基础上加上依托泊苷,但由于目前大部分PTCL患者的总体生存率依旧没有显著提高,我们仍然需要更多的临床实验数据结果来自证实诱导化疗加新型药物的使用对于PTCL的疗效。
First-line therapy for patients with peripheral T-cell lymphoma in the past has been routine CHOP chemotherapy. More recently we are seeing new clinical trials adding new agents to this regimen. Currently, I think the best data is seen adding etoposide to the induction therapy, but we definitely need new clinical trials looking at new agents to add to chemotherapy for induction as most of our current agents to not improve overall survival for patients with PTCL.
《肿瘤瞭望》:对于复发PTCL目前的治疗手段如何?
Vose教授:鉴于PTCL是一类极其难治的淋巴瘤,此类患者进行诱导化疗但几乎所有患者将会复发,因此对于比较年轻的PTCL患者,建议在诱导化疗后进行自体造血干细胞移植。当PTCL患者复发时,大部分患者对于常规治疗方案的缓解率非常低,仅有约30%的复发PTCL患者能通过目前的治疗方案获得缓解。对于此类患者,我们建议他们参与一些临床试验。在美国,目前应用最普遍的新方案当属组蛋白去乙酰化酶抑制剂和携带免疫毒素的单克隆抗体。但由于大部分患者仍不能从这些新药中获益,所以我们建议这些复发患者接受临床试验的治疗。
Unfortunately, when people with peripheral T-cell lymphoma relapse, they have a very low response rate to many of the routine regimens and we do encourage clinical trial participation in many patients. For most of the current regimens we have, patients experience only around a 30% response rate. In the United States, the most common types of new regimens we use would be histone deacetylase inhibitors or monoclonal antibodies with immunotoxins attached. But we definitely recommend clinical trials, because unfortunately, most patients do not respond to even those newer agents. Peripheral T-cell lymphoma is a very difficult lymphoma to treat and we do induction therapy but virtually all patients will relapse after that. So in certain young patients, we do recommend to follow induction therapy with an autologous stem cell transplant. Usually we do not recommend an allogeneic transplant from a donor as part of first remission, but at the time of relapse, we do suggest that sometimes.
《肿瘤瞭望》:对即将到来的“ 世界淋巴瘤日”有何寄语?
Vose教授:每年的9月15日是世界淋巴瘤日,我们纪念这个日子是为了提高淋巴瘤患者的治愈水平。和其他癌症相比,淋巴瘤在很多情况下是一种可以治愈的恶性肿瘤。尽管我们会告诉患者他所患为癌症中较好治的类型,但事实上没有癌症是良性的肿瘤。我们现在仍然在为提高各种癌症患者的至于水平而努力着,我们也将继续为淋巴瘤患者服务尽力治愈。希望在医患共同的努力下,不久的将来淋巴瘤患者的治愈率能有持续不断地提高。
September 15th is World Lymphoma Day. We celebrate that to try to improve our treatments for patients with lymphoma. Lymphoma, in many cases, is a curable type of cancer compared to some others. Even though we may say to patients that this is a good cancer to have, there is no cancer that is a good cancer. As we strive to improve our treatments for all types of patients with cancer, we continue to improve our treatment for lymphoma patients. Hopefully we can continue to increase the cure rates in all patients with lymphoma.