{"id":344167,"date":"2014-11-26T01:00:00","date_gmt":"2014-11-26T00:00:00","guid":{"rendered":"https:\/\/medizinonline.com\/un-nouveau-standard-pour-la-deuxieme-ligne\/"},"modified":"2014-11-26T01:00:00","modified_gmt":"2014-11-26T00:00:00","slug":"un-nouveau-standard-pour-la-deuxieme-ligne","status":"publish","type":"post","link":"https:\/\/medizinonline.com\/fr\/un-nouveau-standard-pour-la-deuxieme-ligne\/","title":{"rendered":"Un nouveau standard pour la deuxi\u00e8me ligne ?"},"content":{"rendered":"<p><strong>Les m\u00e9dicaments qui sont bien \u00e9tablis en premi\u00e8re ligne dans le cancer de l&#8217;estomac avanc\u00e9 permettent toujours d&#8217;obtenir des pronostics de survie relativement faibles en deuxi\u00e8me ligne. Une nouvelle \u00e9tude (RAINBOW) d\u00e9montre d\u00e9sormais l&#8217;efficacit\u00e9 du ramucirumab plus paclitaxel dans cette population. La monoth\u00e9rapie avait \u00e9galement d\u00e9j\u00e0 montr\u00e9 un avantage en termes de survie, ce qui a conduit \u00e0 l&#8217;autorisation de mise sur le march\u00e9 aux \u00c9tats-Unis en avril.<\/strong><\/p>\n<p> <!--more--> <\/p>\n<p><em>(ag) <\/em>Il est clair que le VEGFR-2 joue un r\u00f4le important dans la progression et la pathogen\u00e8se du cancer de l&#8217;estomac. C&#8217;est pr\u00e9cis\u00e9ment l\u00e0 qu&#8217;intervient le ramucirumab, un antagoniste du VEGFR2 : En combinaison avec le paclitaxel, il a montr\u00e9 dans RAINBOW une am\u00e9lioration significative de la survie globale chez les patients pr\u00e9trait\u00e9s.<\/p>\n<h2 id=\"170-centres-27-pays-665-patients\">170 centres, 27 pays, 665 patients<\/h2>\n<p>L&#8217;\u00e9tude, \u00e0 laquelle ont particip\u00e9 pr\u00e8s de 30 pays et 170 centres, a port\u00e9 sur 665 adultes atteints d&#8217;un ad\u00e9nocarcinome gastrique avanc\u00e9 (ainsi que d&#8217;un ad\u00e9nocarcinome de la jonction gastro-\u0153sophagienne) et ayant d\u00e9j\u00e0 \u00e9t\u00e9 trait\u00e9s. Ils ont re\u00e7u soit du ramucirumab plus du paclitaxel (8 mg\/kg, n=330), soit un placebo plus du paclitaxel (n=335).<\/p>\n<h2 id=\"un-benefice-clair\">Un b\u00e9n\u00e9fice clair<\/h2>\n<p>Le crit\u00e8re d&#8217;\u00e9valuation principal, la survie globale, a montr\u00e9 un allongement significatif dans le groupe ramucirumab (m\u00e9diane de 9,6 mois contre 7,4 mois, HR 0,807, p=0,017). Les principaux effets secondaires de grade trois ou plus, plus fr\u00e9quents dans le groupe ramucirumab, \u00e9taient les neutrop\u00e9nies (41 vs 19%), les leucop\u00e9nies (17 vs 7%), l&#8217;hypertension (14 vs 2%), la fatigue (12 vs 5%) et les douleurs abdominales (6 vs 3%). Les neutrop\u00e9nies f\u00e9briles de grade 3 ou plus \u00e9taient rares dans les deux groupes (3 vs 2%).<\/p>\n<p>Les auteurs concluent que le ramucirumab plus paclitaxel est donc justifi\u00e9 comme nouveau standard en deuxi\u00e8me ligne dans le traitement des patients atteints de cancer gastrique avanc\u00e9.<\/p>\n<p><em>Source : Wilke H, et al. : The Lancet Oncology 2014 ; 15(11) : 1224-1235.<\/em><\/p>\n<p><em>InFo ONKOLOGIE &amp; H\u00c4MATOLOGIE 2014 ; 2(9) : 6<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Les m\u00e9dicaments qui sont bien \u00e9tablis en premi\u00e8re ligne dans le cancer de l&#8217;estomac avanc\u00e9 permettent toujours d&#8217;obtenir des pronostics de survie relativement faibles en deuxi\u00e8me ligne. Une nouvelle \u00e9tude&hellip;<\/p>\n","protected":false},"author":7,"featured_media":47875,"comment_status":"closed","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"pmpro_default_level":"","cat_1_feature_home_top":false,"cat_2_editor_pick":false,"csco_eyebrow_text":"\u00c9tude RAINBOW","footnotes":""},"category":[11527,11414,11389,11549],"tags":[49494,15395,49490,34586],"powerkit_post_featured":[],"class_list":["post-344167","post","type-post","status-publish","format-standard","has-post-thumbnail","category-etudes","category-gastro-enterologie-et-hepatologie","category-oncologie","category-rx-fr","tag-antagoniste-du-vegfr2","tag-cancer-de-lestomac-fr","tag-etude-rainbow","tag-paclitaxel-fr","pmpro-has-access"],"acf":[],"publishpress_future_action":{"enabled":false,"date":"2026-04-12 03:11:17","action":"change-status","newStatus":"draft","terms":[],"taxonomy":"category","extraData":[]},"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"wpml_current_locale":"fr_FR","wpml_translations":{"it_IT":{"locale":"it_IT","id":344177,"slug":"nuovo-standard-nella-seconda-linea","post_title":"Nuovo standard nella seconda linea?","href":"https:\/\/medizinonline.com\/it\/nuovo-standard-nella-seconda-linea\/"},"pt_PT":{"locale":"pt_PT","id":344183,"slug":"novo-padrao-na-segunda-linha","post_title":"Novo padr\u00e3o na segunda linha?","href":"https:\/\/medizinonline.com\/pt-pt\/novo-padrao-na-segunda-linha\/"},"es_ES":{"locale":"es_ES","id":344188,"slug":"nueva-norma-en-la-segunda-linea","post_title":"\u00bfNueva norma en la segunda l\u00ednea?","href":"https:\/\/medizinonline.com\/es\/nueva-norma-en-la-segunda-linea\/"}},"_links":{"self":[{"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/posts\/344167","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/comments?post=344167"}],"version-history":[{"count":0,"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/posts\/344167\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/media\/47875"}],"wp:attachment":[{"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/media?parent=344167"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/category?post=344167"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/tags?post=344167"},{"taxonomy":"powerkit_post_featured","embeddable":true,"href":"https:\/\/medizinonline.com\/fr\/wp-json\/wp\/v2\/powerkit_post_featured?post=344167"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}