弥漫大B细胞淋巴瘤治疗新进展PPT.ppt

弥漫大B细胞淋巴瘤治疗新进展 ; 概述 流行病学 基于分子生物学改变的预后评价 治疗进展 初治的DLBCL 难治复发的DLBCL 新药临床试验 ;概述;流行病学;HL及NHL的发病率;弥漫大B细胞淋巴瘤;2010年NCCN指南: Essential Diagnostic Assessments for DLBCL;;Yrs;与弥漫大B细胞淋巴瘤相关的分子遗传学改变;Yrs;Rosenwald A, et al. N Engl J Med. 2002;346:1937-1947. Copyright ? 2002 Massachusetts Medical Society. All rights reserved.;;Lenz G, et al. N Engl J Med. 2008;359:2313-2323.;基于基因表达的风险评分-- 预测DLBCL临床结果;基于基因表达的风险评分-- 预测DLBCL临床结果;基于基因表达的风险评分-- 预测DLBCL临床结果;基于基因表达的风险评分-- 预测DLBCL临床结果;基于基因表达的风险评分-- 预测DLBCL临床结果;弥漫大B细胞淋巴瘤的治疗进展;初治DLBCL;CHOP ± Rituximab in DLBCL:  GELA LNH-98.5 Phase III Study;Maint. Ritux. After R-CHOP or CHOP in Older DLBCL (E4494/C9793 Ph III Study);Cunningham D, et al. ASCO 2009. Abstract 8506.;;LNH03-6B GELA:  R-CHOP-14 vs R-CHOP-21  in Elderly DLBCL Patients;LNH03-6B GELA Trial: Results ;Hematologic toxicities greater for R-CHOP-14 Patients on R-CHOP-14 had higher rates of febrile neutropenia, hospitalization, and death due to toxicity;Pfreundschuh M, et al. Lancet Oncol. 2006;7:379-391.;MInT: 6-Yr Follow-up Data;R-EPOCH 方案;Ph II Study of Dose-Adjusted EPOCH-R in DLBCL (CALGB 50103): PFS by IPI Score;CALGB 50303: R-CHOP vs R-EPOCH in Newly Diagnosed DLBCL;Primary endpoints: OS and PFS Closed: 12/15/07 with 276 randomized patients;复发难治 DLBCL;NCCN Guideline Recommendations for Treatment of Relapsed DLBCL;治疗DLBCL的新药临床试验;DLBCL研究中的药物 (Off-Label Use);治疗DLBCL的研究中的药物: Phase II Data;Bortezomib (硼替佐米)+ CHOP-R作为DLBCL的一线治疗;Bendamustine (苯达莫司汀) + Rituximab for Rel/Ref DLBCL: Phase II Study;Bendamustine+ Rituximab for Rel/Ref DLBCL: Preliminary Phase II Results;Everolimus(依维莫司): Ongoing Phase II and III Studies in DLBCL;Phase II R-CHOP plus bevacizumab for first-line treatment of DLBCL[1] Bevacizumab plus R-CHOP for first-line treatment of stage II-IV DLBCL[2] Phase III R-CHOP vs R-CHOP plus bevacizumab for first-line trea