FMC-HGE : Association Française de Formation Médicale Continue en Hépato-Gastro-Entérologie

sur 500~20000

599

Mélange de bons et de mauvais. Gains et pertes d'accompagnement féroce

4

172.67.167.223

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d'Hépato-gastroentérologieetd'OncologieDigestive Du17au20mars2022àParis HGE2.0 ProgrammedelaFMCHGE "usestrict";function_toConsumableArray(e){if(Array.isArray(e)){for(vart=0,i=Array(e.length);t Congrès AASLD2024   Du15au19novembre2024 AmericanAssociationfortheStudyofLiverDiseases SanDiego -Californie LesJournéesdeColo-ProctologiedelaSNFCP2024   Du14au16novembre2024 LesJournéesdeColo-ProctologiedelaSNFCP Paris -France ECCO2025   Du19au22février2025 EuropeanCrohn'sandColitisOrganisation Berlin -Allemne ESGEDAYS2025   Du3au5ril2025 EuropeanSocietyofGastrointestinalEndoscopy Barcelone -Espne EASL2025   Du7au10mai2025 EuropeanAssociationfortheStudyoftheLiver Amsterdam -Pays-Bas Voirtouslescongrès LaBrèvedujour EssaiMOONLIGHT:duclairetduplusobscur? RetoursurlecongrèsESMO2024 Auteur(s)dutextederéférence:SylvieLorenzen, Munich, GermanyModifiedFOLFOXplus/minusnivolumabandipilimumabvsFLOTplusnivolumabinpatientswithpreviouslyuntreatedadvancedormetastaticadenocarcinomaofthestomachorgastroesophealjunction:FinalresultsoftheIKF-AIO-Moonlighttrial Rédacteur(s)delabrève:MargotPIZZAMIGLIO PositionduproblèmeFOLFOX+nivolumab(nivo)estdevenuletraitementstandarddepremièreligne(1L)pourlespatients(pts)atteintsd’unadénocarcinomeoesogastriquemétastatique(ADKOGm)HER2-,PDL-1CPS≥5.L'essaiMOONLIGHTestunessaidephase2évaluantchezlesptsatteintsd'unADKOGmHER2-(toutCPSPDL-1)l'intérêtd'optimiserletraitementeca)l'ajoutd'unedoubleimmunothérapieparNivo+ipiauFOLFOX,administrésenparallèle(brasA1)ouenséquentiel(brasA2)parrapportauFOLFOXseul(brasB)ouecb)untripletdechimiothérapie(FLOT)+nivo(brasC).MéthodeLesptsontétérandomisés1:1entrelebrasAetlebrasBpuis,en2:1entrelebrasA1etlebrasA2.Enfin,lespatientsontétérépartisdanslebrasuniqueC.Larandomisation/stratificationdesptsaétéfaitesanstenircomptedustatutCPSPDL-1.L'objectifprincipalétaitlasurviesansprogression(SSP)pourlebrasAcontrelebrasBetletauxdeSSPà6moispourlesbrasA2etC.LesprincipauxcritèressecondairesétaientlaSSP,laSGetletauxderéponseobjective(TRO).RésultatUntotalde262ptsontétéinclus:brasA(n=60),brasB(n=60),brasA1(n=30),brasA2(n=60)etbrasC(n=52).Lesuivimédianestde9.3mois.LescaractéristiquesdedépartdelapopulationétaientcomparablesdanstouslesbrasecdesCPSPDL-1globalementfaiblesvariantsde38%(brasB)à65%(brasC).LesdonnéesdeSSP/SGétaient:brasA15.8/10.1;A24.0/7.6;B6.6/12.5etC7.0/14.6mois,forisantleschémad'administrationenparallèlepourlebrasAsanspourautantretrouverdebénéficeentermedeSSPdubrasA(A1/A2)parrapportaubrasB.LatoxicitéétaitgérabledanstouslesbrasdetraitementecdestauxplusimportantsdanslebrasA. 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