Det har vel blitt nevnt flere ganger at effekten ikke vil synes før Q1(da mener Q4 pres i februar), tidligst. Poenget er vel at det også ble nevnt at endringene er på plass i best recruiting countries, samt SCT endringer er ikke like viktig i alle land og hvis de har fått dette på plass hvor nødvendig har gjerne ikke “guidingen” på akkurat dette punktet så mye å si.
Ellers kan dette gi et bilde over hvor mange pasienter som har vært ekskludert fra PARADIGME:
Introduction
In 2016, approximately over 80,000 cases of lymphoma were diagnosed in the United States with just over 20,000 lymphoma related deaths during the same period [1]. Chemotherapy remains the first line standard of care for aggressive lymphomas. Roughly 20–30% of patients with non-Hodgkin lymphoma (NHL) will not be able to achieve a complete remission (CR) with standard induction like R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) [2]. For relapsed or refractory (R/R) NHL patients, use of a salvage chemotherapy (ST) regimen and high dose chemotherapy (HDT) consolidation with use of autologous stem cell transplant (ASCT) can be curative [3,4]. Evidence for the utility of HDT comes from a study by Philip et al. (1995) comparing ST to HDT followed by ASCT in patients with high grade lymphoma of both B-cell and T-cell subtypes. After a 5-year follow-up, overall survival (OS) was 53% in the HDT/ASCT group compared to 32% in the ST group (P value = 0.038) [3]. Several investigators have looked at the use of upfront ASCT consolidation in aggressive NHL [5,7]. In a study of chemosensitive HL patients in their first relapse, by Schmitz et al. (2002) showed 55% patients randomized to ASCT were disease free at 3-years compared to 34% of patients who received aggressive conventional chemotherapy (CHT) alone but there was no difference in OS [4]. Upfront consolidation was attempted in advanced HL [8,9] but without OS advantage. For high-risk HD in the primary refractory setting, tandem transplant has been evaluated with limited success [10].
For relapsed or refractory (R/R) NHL patients, use of a salvage chemotherapy (ST) regimen and high dose chemotherapy (HDT) consolidation with use of autologous stem cell transplant (ASCT) can be curative [3,4].
Hvis dette er nokså standard behandling for R/R FL i f.eks US så tror jeg vi vil se nokså
bra rekrutteringstakt neste presentasjon.
