Wolfromm A, Delarue R
Service d'hématologie, hôpital Necker-Enfants-Malades, 149, rue de Sèvres, 75015 Paris, France.
Service d'hématologie, hôpital Necker-Enfants-Malades, 149, rue de Sèvres, 75015 Paris, France.
Rev Med Interne. 2017 Oct;38(10):685-690. doi: 10.1016/j.revmed.2017.07.007. Epub 2017 Sep 28.
Emergence of new molecules has considerably reshaped the management of patients in onco-hematology. Cytotoxic chemotherapy has not been altered, and CHOP remains the reference treatment for lymphomas. However, the development of targeted therapies has allowed for a broader spectrum of treatments. Immunotherapy with monoclonal antibodies entered the market with rituximab in diffuse large B-cell lymphomas, in the 1990s and it is now developing as new-generation anti-CD20 antibodies (obinotuzumab and ofatumumab). Anti-CD30 antibodies have been proposed in the treatment of T lymphomas and Hodgkin lymphomas. More recently, anti-PD1 antibodies have brought new perspectives in several cancers and more specifically in Hodgkin's lymphoma. Finally the BTK inhibitor, ibrutinib developed in the LLC has established itself in the management of mantle cell lymphoma and Waldenström macroglobulinemia. How can we deal with all these new molecules? Should they be offered as monotherapy or in association? In first line or relapse? The objective of this review is to trace history of the latest advances, and to highlight the validated strategies representing the new standards of treatment of lymphomas in 2017.
新分子的出现极大地改变了血液肿瘤患者的治疗方式。细胞毒性化疗并未改变，CHOP方案仍然是淋巴瘤的参考治疗方案。然而，靶向治疗的发展使得治疗手段更加多样化。20世纪90年代，利妥昔单抗作为单克隆抗体免疫疗法进入弥漫性大B细胞淋巴瘤市场，如今新一代抗CD20抗体（奥滨尤妥珠单抗和奥法木单抗）正在研发中。抗CD30抗体已被用于治疗T淋巴瘤和霍奇金淋巴瘤。最近，抗PD1抗体为多种癌症，尤其是霍奇金淋巴瘤带来了新的治疗前景。最后，在有限责任公司研发的布鲁顿酪氨酸激酶（BTK）抑制剂伊布替尼已在套细胞淋巴瘤和华氏巨球蛋白血症的治疗中确立了地位。我们该如何应对所有这些新分子呢？它们应该作为单一疗法还是联合疗法使用？一线治疗还是复发治疗？这篇综述的目的是追溯最新进展的历程，并突出代表2017年淋巴瘤治疗新标准的有效策略。
