Choosing frontline chemoimmunotherapy for CLL
Mené sur 561 patients atteints d'une leucémie lymphocytaire chronique sans délétion 17p, cet essai randomisé international de phase III compare l'efficacité, du point de vue de la survie sans progression, et la toxicité du traitement de référence (fludarabine, cyclophosphamide, rituximab) et d'un traitement potentiellement moins toxique (bendamustine, rituximab)
Chronic lymphocytic leukaemia has long been considered incurable with conventional therapies. However, long-term follow-up of trials investigating the combination of fludarabine, cyclophosphamide, and the anti-CD20 antibody rituximab, as frontline therapy suggests otherwise. A subset of patients have remained disease-free more than 10 years after completion of initial treatment, even when assessed with highly sensitive flow-cytometric assays. However, these highly durable responses appear limited to patients with the more favourable IGHV mutated subtype of chronic lymphocytic leukaemia.
The Lancet Oncology , commentaire, 2015