Management and clinical outcomes of follicular lymphoma across continuous lines of treatments: a retrospective analysis in China.
Management and clinical outcomes of follicular lymphoma across continuous lines of treatments: a retrospective analysis in China.
复制标题
DOI：
10.3389/fonc.2023.1264723
复制
发表时间：
2023
影响因子：
4.7
通讯作者：
中科院分区：
文献类型：
--
作者：
滤泡性淋巴瘤 (FL) 的特点是病程无法治愈，通常需要多线治疗。尽管一系列新方法拓宽了后期患者的治疗选择，但有关中国复发/难治性 (R/R) FL 患者的治疗模式和结果的数据却很少报道。这项回顾性单中心研究纳入了 2002 年 1 月至 2019 年 12 月期间在我们机构诊断为 1-3a 级 FL 的患者。根据干预措施和类型对感兴趣的终点进行了分析。终点主要包括总缓解率（ORR）、无进展生存期（PFS）和总生存期（OS）。该研究招募了 566 名经活检证实的患者。其中，544名患者开始一线治疗，其次是240名患者开始二线治疗，146名患者开始第三线治疗，88名患者开始第四线治疗，47名患者开始第五线治疗，28名患者开始第六线治疗。从治疗模式来看，抗CD20化疗是一线和二线的主要治疗方式。然而，对于三线及后续线的患者，治疗方法多种多样，参与新药临床试验的情况也很常见，这与生存获益相关。研究还显示，临床指标（例如 ORR、PFS 和 OS）随着后续的每一次治疗而逐渐下降。一线的 ORR 为 86.6%，但三线和六线分别降至 48.6% 和 40.4%。同样，第三线的中位 OS 和 PFS 分别降至 88.8 个月和 7.1 个月，第六线进一步降至 21.7 个月和 2.8 个月。共有 133 名患者在一线抗 CD20 化疗（POD24）开始后 24 个月内出现病情进展，与非 POD24 组相比，这些患者在后续治疗中表现出较差的反应率和结果。本研究揭示了中国人群中 R/R FL 患者的临床常规实践和预后。它强调了对提高生存率的最佳策略的需求尚未得到满足，并且也作为未来试验的基准。
Follicular lymphoma (FL) is characterized by an incurable course that frequently necessitates multiple lines of treatment. While a range of new approaches have broadened therapeutic options for patients in later lines, data regarding treatment patterns and outcomes of Chinese patients with relapsed/refractory(R/R) FL was scarcely reported. This retrospective single-center study included patients diagnosed with FL grades 1–3a at our institution between January 2002 and December 2019. Endpoints of interest were analyzed according to lines and types of interventions. The endpoints mainly included overall response rate (ORR), progression-free survival (PFS), and overall survival (OS). The study enrolled 566 biopsy-proven patients. Among them, 544 patients initiated the first line of treatment, followed by 240 initiating the second line, 146 initiating the third line, 88 initiating the fourth line, 47 initiating the fifth line, and 28 initiating the sixth line. In terms of treatment patterns, anti-CD20 chemotherapy was a major modality in the first and second lines. However, for patients in the third line and subsequent lines, treatment approaches were diverse, and participation in clinical trials for new medications was common, which correlated with a survival benefit. The study also revealed that clinical indicators (such as ORR, PFS, and OS) gradually decreased with each subsequent line of treatment. The ORR at the first line was 86.6%, but decreased to 48.6% at the third line and 40.4% at the sixth line, respectively. Similarly, median OS and PFS decreased to 88.8 and 7.1 months at the third line and further reduced to 21.7 and 2.8 months at the sixth line, respectively. A total of 133 patients developed progression within 24 months from the initiation of first line anti-CD20 chemotherapy (POD24), and these patients exhibited poorer response rates and outcomes in subsequent lines of therapycompared to the non-POD24 group. This study revealed the clinical routine practices and prognosis of R/R FL patients within the Chinese population. It underscored the unmet need for optimal strategies to improve survival and also served as a benchmark for future trials.
登录
查看更多内容
影响因子：
7.5
作者：
Salles, Gilles;Schuster, Stephen J.;Dreyling, Martin;Fischer, Luca;Kuruvilla, John;Patten, Piers E. M.;von Tresckow, Bastian;Smith, Sonali M.;Jimenez-Ubieto, Ana;Davis, Keith L.;Anjos, Carla;Chu, Jufen;Zhang, Jie;Bodoni, Chiara Lobetti;Thieblemont, Catherine;Fowler, Nathan H.;Dickinson, Michael;Martinez-Lopez, Joaquin;Wang, Yucai;Link, Brian K.
通讯作者：
Link, Brian K.
影响因子：
45.3
作者：
Dreyling, Martin;Santoro, Armando;Zinzani, Pier Luigi
通讯作者：
Zinzani, Pier Luigi
影响因子：
6.2
作者：
Evens, Andrew M.;Vanderplas, Ann;Friedberg, Jonathan W.
通讯作者：
Friedberg, Jonathan W.
影响因子：
51.1
作者：
Budde, Lihua E.;Sehn, Laurie H.;Bartlett, Nancy L.
通讯作者：
Bartlett, Nancy L.
影响因子：
20.3
作者：
Bartlett, Nancy L.;Costello, Brian A.;Fehniger, Todd A.
通讯作者：
Fehniger, Todd A.