外周T细胞淋巴瘤诊疗进展张智慧.ppt

Brentuximab Vedotin + 化疗一线治疗ALCL I 期临床试验: 39 pts 高危ALCL (IPI ≥ 2) or CD30+ 成熟T-cell/NK-细胞淋巴瘤 随机分为3组 1.8 mg/kg brentuximab vedotin q3w X 2 cycles, then CHOP x 6 cycles 1.8 mg/kg brentuximab vedotin + CHP q3w for up to 6 cycles Determine optimal dose of brentuximab vedotin to be used in combination with CHP in third arm Responders receive additional cycles of brentuximab vedotin monotherapy ORR: 100% (26/26); CR: 88% (23/26) Brentuximab vedotin MTD not exceeded at 1.8 mg/kg 1 DLT: grade 3 rash in 6 pts 治疗相关并发症: 恶心(58%), 疲乏 (50%), 腹泻(50%), 周围神经病变 (38%), 脱发(38%) Fanale MA, et al. ASH 2012. Abstract 60. Pro B, et al. J Clin Oncol. 2012;30:2190-2196. Brentuximab Vedotin in Rel/Ref Systemic ALCL: Maximum Tumor Reduction (IRC) Tumor Size (% changefrom baseline) -100 -50 0 50 100 Individual Patients (n = 57) Best clinical response Complete remission Partial remissionStable diseaseProgressive disease Histologically ineligible Dueck G, et al. Cancer. 2010;116:4541-4548. 来啦度胺 II 期临床试验：24 PTCL Pts.（ N = 24） ORR: 30% (7/23) All PRs 所有亚型都有效 Median PFS: 96 days Median OS: 241 days AEs:中性粒细胞减少、疼痛、血小板减少、皮疹 Interim report of a phase 2 clinical trial of lenalidomide for T-cell non-Hodgkin lymphoma Relapsed/refractory PTCL ECOG PS 0-2 (N = 24) Lenalidomide 25mg PO qd on Days 1-21 of a 28day cycle The primary endpoint ；ORR? The secondary endpoints: OS, PFS, and safety. open-label, single-arm, multicenter Canadian phase 2 clinical trial? September 2006 to November 2008, Cancer Volume116.Issue 19. pages 4541–4548,?1 October 2010 PD or Intolerable Interim report of a phase 2 clinical trial of lenalidomide for T-cell non-Hodgkin lymphoma Cancer Volume116.Issue 19. pages 4541–4548,?1 October 2010 Alisertib: Investigational Aurora A Kinase Inhibitor Results in mitotic defects Abnormal spindles Unseparated centrosomes Delayed mitotic progression Apoptosis or senescence Untreated Treated Treated N CI O F N N HN O OH O Friedberg J, et al. ASH 2011. Abstract 95. Frie