OMEDIT RHONE ALPES - AUVERGNE RESEAUX DE ......OMEDIT / 27_04_09 REGIONS RHONE-ALPES ET AUVERGNE -...

OMEDIT / 27_04_09

REGIONS RHONE-ALPES ET AUVERGNE - REFERENTIELS COMM UNS DE PROTOCOLES DE CHIMIOTHERAPIE sur 37

OMEDIT RHONE ALPES - AUVERGNE RESEAUX DE CANCEROLOGIE RHONE-ALPES ET AUVERGNE

GROUPE DE TRAVAIL REFERENTIELS COMMUNS DE PROTOCOLE S DE CHIMIOTHERAPIE

REFERENTIEL DE BON USAGE - CANCERS HEMATOLOGIQUES : LYMPHOMES ET MYELOMES

Rappel : équivalence reconnue par l’INCa entre la forme orale et la forme IV de fludarabine

I- CONDITIONNEMENTS DE GREFFE POUR LES LYMPHOMES ET LES MYELOMES A- PROTOCOLES ENREGISTRES EN RCP

Intitulé du protocole Schéma thérapeutique Stade Groupe de référence

Références bibliographiques

MILPIED ET AL. [68]

BEAM

- Carmustine 300 mg/m² J1 - Cytarabine

200 à 400 mg/m² J2, J3, J4, J5 - Etoposide

200 à 400 mg/m² J2, J3, J4, J5 - Melphalan inj 140 mg/m² J6

- A - I

LINCH ET AL. [58]

CBV

- Etoposide 250 mg/m² J1, J2, J3, J4

- Cyclophosphamide 1500 mg/m² J1, J2, J3, J4

- Carmustine 300 mg/m² J4

- A - I HAIOUN ET AL. [43]

HAIOUN ET AL. [45]

CBV - MITOXANTRONE

- Mitoxantrone 30 ou 45 mg/m² J1


- Cyclophosphamide 1500 mg/m² J2, J3, J4, J5


- A - I

MORSCHHAUSER ET AL. [71]

TAM

- TBI - Cytarabine

3000 mg/m² J1, J2 - Melphalan inj 140 mg/m² J3

- A - Médicaments non inscrits sur la liste hors GHS


OMEDIT / 27_04_09




BAM

- Busulfan inj 4 mg/kg J1, J2, J3

- Cytarabine 3000 mg/m² J4, J5

- Melphalan inj 140 mg/m² J6

- A - II MORSCHHAUSER ET AL. [71]

CYCLOPHOSPHAMIDE - TBI - Cyclophosphamide

60 mg/kg J1, J2 - TBI

- A - Médicament

non inscrit sur la liste hors GHS

GRATWOHL [39]

CYCLOPHOSPHAMIDE - VP16 - TBI

- Cyclophosphamide 60 mg/kg J1, J2

- Etoposide 150 mg/m² J1, J2

- TBI


SEBBAN ET AL. [87]

MELPHALAN EN MONOTHERAPIE

Melphalan inj 200 mg/m² J1

- A - Médicament


MOREAU ET AL. [69]

MELPHALAN - TBI - Melphalan inj 140 mg/m² J1

- TBI -

A - Médicament non inscrit sur la

liste hors GHS

ATTAL ET AL. [4]

BUSULFAN - CYCLOPHOSPHAMIDE (BuCy2)

- Busulfan inj 3,2 mg/kg J1, J2, J3, J4 - Cyclophosphamide

60 mg/kg J5, J6

- A - I GRATWOHL [39]

BUSULFAN - MELPHALAN (BuMEL)

- Busulfan inj 3,2 mg/kg J1, J2, J3, J4

- Melphalan 140 mg/m² J5

- A - II GRATWOHL [39]

BARON ET AL. [6] FLUDARABINE - TBI

(CONDITIONNEMENT ATTENUE) Fludarabine inj

30 mg/m² J1, J2, J3 -


liste hors GHS GRATWOHL [39]

FLUDARABINE - MELPHALAN (CONDITIONNEMENT ATTENUE)

- Fludarabine inj 30 mg/m² J1, J2, J3, J4

- Melphalan inj 140 mg/m² J4


GIRALT ET AL. [35]

OMEDIT / 27_04_09


B- PROTOCOLES DISCUTES EN RCP (DE 1er NIVEAU OU DE RECOURS) PRESCRIPTION A DEFAUT, PAR EXCEPTION ET EN L’ABSENC E D’ALTERNATIVE THERAPEUTIQUE POUR LE PATIENT



Z-BEAM

- Rituximab 250 mg/m² J1, J8

- 90Y Ibritumomab Tiuxétan 14,8 MBq/kg J8 - Carmustine

150 mg/m² J15, J16 - Cytarabine

200 mg/m² J17, J18, J19, J20 - Etoposide

200 mg/m² J17, J18, J19, J20 - Melphalan inj 140 mg/m² J21

- B - Annexe INCa KRISHNAN ET AL. [56]

C- PROTOCOLES NON AUTORISES Pas de protocole

OMEDIT / 27_04_09


II- LYMPHOMES B DIFFUS A GRANDES CELLULES ET AUTRES LYMPHOMES B AGRESSIFS A- PROTOCOLES ENREGISTRES EN RCP



R-CHOP

(Sous cette appellation standard sont également regroupées les

atténuations de doses : R-Mini CHOP par exemple)

- Rituximab 375 mg/m² J1

- Cyclophosphamide 750 mg/m² J1

- Doxorubicine 50 mg/m² J1 - Vincristine 1,4 mg/m² J1

Dose totale maximale : 2 mg - Prednisone per os

40 mg/m² J1 à J5 Tous les 14 à 21 jours

Possibilité de substitution de : - la vincristine, par la vindésine ou l’étoposide ;

- la doxorubicine, par l’épirubicine.

CD20 + (1ère ligne)

A - I COIFFIER ET AL. [11]

ACVBP

- Doxorubicine 75 mg/m² J1


- Vindésine 2 mg/m² J1, J5 - Bléomycine

10 mg dose totale J1, J5 - Prednisone per os


1ère ligne A - Médicaments non inscrits sur la liste hors GHS

TILLY ET AL. [93]

METHOTREXATE HAUTE DOSE EN MONOTHERAPIE

Méthotrexate 3000 mg/m² J1

Tous les 14 jours 1ère ligne


liste hors GHS

TILLY ET AL. [93]

IFOSFAMIDE - ETOPOSIDE

- Ifosfamide 1500 mg/m² J1

- Etoposide 300 mg/m² J1

Tous les 14 jours


TILLY ET AL. [93]

CYTARABINE EN MONOTHERAPIE

Cytarabine SC 100 mg/m² J1, J2, J3, J4



liste hors GHS

TILLY ET AL. [93]

OMEDIT / 27_04_09




GHESQUIERES ET AL. [33]

COP

- Cyclophosphamide 300 mg/m² J1 - Vincristine

1 mg/m² J1, dose totale maximale : 2 mg - Méthotrexate intrathécal

15 mg dose totale J1 - Hydrocortisone intrathécale

15 mg dose totale J1 - Méthylprednisolone inj

2 mg/kg J1 à J6

Formes cérébrales et Burkitt Préphase (1ère ligne)

A - Médicaments non inscrits sur la liste hors GHS

DIVINE ET AL. [22]


COPADEM

- Méthotrexate 3000 mg/m² J1 - Vincristine

1,4 mg/m² J1, dose totale maximale : 2 mg - Méthotrexate intrathécal

15 mg dose totale J2, J6 - Hydrocortisone intrathécale

15 mg dose totale J2, J6 - Méthylprednisolone inj

2 mg/kg J1 à J6 - Doxorubicine

60 mg/m² J2 - Cyclophosphamide

500 mg/m² J2 à J4 - Acide folinique inj

100 mg dose totale J2 à J4 Tous les 21 jours

Formes cérébrales et Burkitt (1ère ligne)


DIVINE ET AL. [22]


CYM

- Méthotrexate 3000 mg/m² J1

- Méthotrexate intrathécal 15 mg dose totale J2

- Hydrocortisone intrathécale 15 mg dose totale J2, J6

- Cytarabine 100 mg/m² J2 à J6

- Acide folinique inj 100 mg dose totale J2 à J4 - Cytarabine intrathécale

30 mg dose totale J6 Tous les 21 jours

Formes cérébrales et Burkitt (1ère ligne)


DIVINE ET AL. [22]

OMEDIT / 27_04_09




Lymphomes de Burkitt (1ère ligne)

DIVINE ET AL. [22]

CYVE

- Cytarabine 50 mg/m² J1, J2, J3, J4, J5

- Cytarabine 2000 mg/m² J2, J3, J4, J5

- Etoposide 200 mg/m² J2, J3, J4, J5 Tous les 21 à 28 jours

Lymphomes cérébraux En rechute

(≥ 2ème ligne)


SOUSSAIN ET AL. [89]

MVBP

- Méthotrexate 3000 mg/m² J1, J15

- Etoposide 100 mg/m² J2 - Carmustine 100 mg/m² J3

- Méthylprednisolone inj 60 mg/m² J1, J2, J3, J4, J5

Tous les 21 jours

Lymphomes cérébraux (1ère ligne)

A - I COLOMBAT ET AL. [13]

IFOSFAMIDE - CYTARABINE

- Ifosfamide 1500 mg/m² J1, J2, J3

- Cytarabine 2000 mg/m² J1, J2

Lymphomes cérébraux (1ère ligne)


COLOMBAT ET AL. [13]

DHAP

(En cas de contre-indication au cisplatine, possibilité d’utiliser du

carboplatine AUC 5, selon Calvert ou Chatelut : CARBO-DHAP )

- Dexaméthasone inj 40 mg dose totale J1 à J4

- Cisplatine 100 mg/m² J1 - Cytarabine

4000 mg/m² J2 Tous les 21 jours

En rechute (≥ 2ème ligne)


VELASQUEZ ET AL. [95]

ICE

- Etoposide 100 mg/m² J1, J2, J3

- Carboplatine AUC 5 (Calvert ou Chatelut) J2


Tous les 14 jours



MOSKOWITZ ET AL. [72]

OMEDIT / 27_04_09




ESHAP


- Cisplatine 25 mg/m² J1, J2, J3, J4

- Méthylprednisolone inj 500 mg dose totale J1, J2, J3, J4, J5

- Cytarabine 2000 mg/m² J5

Tous les 21 jours




WILSON ET AL. [99]

GUTIERREZ ET AL. [41]

EPOCH

- Prednisone per os 60 mg/m² J1 à J6 - Doxorubicine


50 mg/m² J1, J2, J3, J4 - Vincristine

0,4 mg/m² J1, J2, J3, J4 Dose totale maximale : 2 mg


Tous les 21 jours



WILDER ET AL. [98]

MIV

- Mitoxantrone 10 mg/m² J1 - Ifosfamide

1500 mg/m² J1, J2, J3 - Etoposide

150 mg/m² J1, J2, J3 Tous les 21 jours



BOSLY ET AL. [9]

NIMP

- Vinorelbine 25 mg/m² J1, J15

- Ifosfamide 1000 mg/m² J1, J2, J3, J4, J5

- Mitoxantrone 10 mg/m² J1

- Prednisone per os 1 mg/kg J1, J2, J3, J4, J5

Tous les 28 jours



MAKOWSKI ET AL. [62]

OMEDIT / 27_04_09




CHAU ET AL. [10]

DHAOx


- Oxaliplatine 130 mg/m² J1 - Cytarabine



en cas d’insuffisance

rénale


MACHOVER ET AL. [61]

CYTARABINE EN SUSPENSION INJECTABLE (DEPOCYTE®)

EN MONOTHERAPIE

Traitement d’induction Cytarabine susp intrathécale

50 mg dose totale S1, S3 2 injections à 14 jours d’intervalle

Traitement de consolidation

Cytarabine susp intrathécale 50 mg dose totale S5, S7, S9, S13

3 injections à 14 j d’intervalle et une 4 ème 28 j après

Traitement de maintenance Cytarabine susp intrathécale

50 mg dose totale S17, S21, S25, S29 4 injections à 28 jours d’intervalle

Méningite lymphomateuse

En curatif A - I GLANTZ ET AL.

[37]

DELRIEU ET AL. [18]

HAIOUN ET AL. [44]

MILPIED ET AL. [68]

TILLY ET AL. [93]


METHOTREXATE +/- CYTARABINE +/- CORTICOIDE

- Méthotrexate intrathécal 15 mg dose totale

+/- Cytarabine intrathécale 30 mg dose totale

+/- Méthylprednisolone ou hydrocortisone intrathécale

15 mg dose totale


En prophylaxie et en curatif


DIVINE ET AL. [22]

OMEDIT / 27_04_09





BELHADJ ET AL. [7]

R-ACVBP







CD20 + (1ère ligne)

B - Annexe INCa

MOUNIER ET AL. [73]

R-IFOSFAMIDE - ETOPOSIDE

- Rituximab 375 mg/m² J1 - Ifosfamide

1500 mg/m² J1 - Etoposide


CD20+ (1ère ligne)

B - Annexe INCa NCT00140595

MEY ET AL. [66]

MEY ET AL. [67]

R-DHAP


carboplatine AUC 5, selon Calvert ou Chatelut : R-CARBO-DHAP )





CD20+ En rechute

(≥ 2ème ligne) B - Annexe INCa

GISSELBRECHT ET AL. [36]

KEWALRAMANI ET AL. [54]

R-ICE

- Rituximab 375 mg/m² J1 - Etoposide

100 mg/m² J1, J2, J3 - Carboplatine

AUC 5 (Calvert ou Chatelut) J2 - Ifosfamide


CD20+ En rechute


GISSELBRECHT ET AL. [36]

OMEDIT / 27_04_09




SHRESTHA ET AL. [88]

HICKS ET AL. [48]

R-ESHAP


40 mg/m² J1, J2, J3, J4 - Cisplatine

25 mg/m² J1, J2, J3, J4 - Méthylprednisolone inj

500 mg dose totale J1, J2, J3, J4, J5 - Cytarabine


CD20+ En rechute


MARTIN ET AL. [64]

R-EPOCH




50 mg/m² J1, J2, J3, J4 - Vincristine

0,4 mg/m² J1, J2, J3, J4, Dose totale maximale : 2 mg


Tous les 21 jours

CD20+ En rechute

(≥ 2ème ligne) B - Annexe INCa JERMANN ET AL.

[52]

R-MIV





CD20+ En rechute

(≥ 2ème ligne) B - Annexe INCa VELLENGA ET AL.

[97]

OMEDIT / 27_04_09




R-NIMP

- Rituximab 375 mg/m² J1 - Vinorelbine

25 mg/m² J1, J15 - Ifosfamide

1000 mg/m² J1, J2, J3, J4, J5 - Mitoxantrone

10 mg/m² J1 - Prednisone per os

1 mg/kg J1, J2, J3, J4, J5 Tous les 28 jours

CD20+ En rechute

(≥ 2ème ligne) B - Annexe INCa VELLENGA ET AL.

[97]

GEMOX

- Gemcitabine 1000 mg/m² J1 - Oxaliplatine 100 mg/m² J1

Tous les 14 jours


B - Annexe INCa CORAZZELLI ET AL. [15]

LOPEZ ET AL. [60]

R-GEMOX

- Rituximab 375 mg/m² J1 - Gemcitabine 1000 mg/m² J1 - Oxaliplatine 100 mg/m² J1

Tous les 14 jours

CD20+ En rechute


EL GNAOUI ET AL. [25]

C- PROTOCOLES NON AUTORISES

Intitulé du protocole Schéma thérapeutique Stade Groupe de référence Références bibliographiques

IDARUBICINE INJ - 1ère ligne C - III -

IDARUBICINE PER OS - - C - III -

FLUDARABINE EN MONOTHERAPIE - -

C - Médicament non inscrit sur la liste

hors GHS -

R-FC - - C - Absent du

référentiel de l’INCa -

ALEMTUZUMAB - - C - Absent du

référentiel de l’INCa -

OMEDIT / 27_04_09


III- LYMPHOMES T A- PROTOCOLES ENREGISTRES EN RCP Lymphomes cérébraux de phénotype T : se reporter au traitement des lymphomes cérébraux de phénotype B, détaillé dans le chapitre précédent



CHOP


atténuations de doses : Mini CHOP par exemple)








BONNET ET AL. [8]

ACVBP







TILLY ET AL. [93]

METHOTREXATE HAUTE DOSE EN MONOTHERAPIE

Méthotrexate 3000 mg/m² J1



liste hors GHS

TILLY ET AL. [93]

IFOSFAMIDE - ETOPOSIDE


- Etoposide 300 mg/m² J1

Tous les 14 jours


TILLY ET AL. [93]

CYTARABINE EN MONOTHERAPIE

Cytarabine SC 100 mg/m² J1, J2, J3, J4



liste hors GHS

TILLY ET AL. [93]

OMEDIT / 27_04_09




DHAP









ICE


- Carboplatine AUC 5 (Calvert ou Chatelut) J2


Tous les 14 jours



MOSKOWITZ ET AL. [72]

ESHAP


- Cisplatine 25 mg/m² J1, J2, J3, J4

- Méthylprednisolone inj 500 mg dose totale J1, J2, J3, J4, J5

- Cytarabine 2000 mg/m² J5

Tous les 21 jours




GUTIERREZ ET AL. [41]

EPOCH



50 mg/m²J1, J2, J3, J4 - Vincristine

0,4 mg/m² J1, J2, J3, J4, dose totale maximale : 2 mg - Cyclophosphamide




WILDER ET AL. [98]

MIV






BOSLY ET AL. [9]

OMEDIT / 27_04_09




SWIERCZ ET AL. [90]

VIP


- Ifosfamide 1000 mg/m² J1, J2, J3, J4, J5

- Cisplatine 20 mg/m² J1, J2, J3, J4, J5

Tous les 28 jours


A - Médicaments non inscrits sur la

liste hors GHS NICOLAS ET AL.

[74]

CHAU ET AL. [10]

DHAOx


- Oxaliplatine 130 mg/m² J1 - Cytarabine



en cas d’insuffisance rénale


liste hors GHS MACHOVER ET AL.

[61]


EN MONOTHERAPIE



Traitement de consolidation Cytarabine susp intrathécale


et une 4 ème 28 jours après



Méningite lymphomateuse En curatif

A - I GLANTZ ET AL. [37]

DELRIEU ET AL. [18]

MILPIED ET AL. [68]





15 mg dose totale

Méningite lymphomateuse En prophylaxie et en curatif


liste hors GHS TILLY ET AL.

[93]

OMEDIT / 27_04_09



Pas de protocole






FLUDARABINE EN MONOTHERAPIE - -

C - Médicament non inscrit sur la

liste hors GHS -

R-FC - - C - Absent du référentiel de

l’INCa -

VINORELBINE - En rechute

(≥ 2ème ligne)

C - Médicament non inscrit sur la

liste hors GHS -

OMEDIT / 27_04_09


IV- LYMPHOMES FOLLICULAIRES A- PROTOCOLES ENREGISTRES EN RCP



R-CHOP







40 mg/m² à 100 mg dose totale J1 à J5 Tous les 21 jours



Stades III-IV 1ère ligne

A - I HIDDEMANN ET AL. [49]

R-CVP


- Cyclophosphamide 750 mg/m² J1 - Vincristine 1,4 mg/m² J1


40 mg/m² J1 à J5 Tous les 21 jours

Stades III-IV 1ère ligne

A - I MARCUS ET AL. [63]

Rituximab 375 mg/m² J1

Tous les 7 jours, pendant 4 semaines

Stades III-IV En cas de chimiorésistance ou à

partir de la 2ème rechute (≥ 2ème ligne)

A - I MCLAUGHLIN ET AL. [65]

RITUXIMAB EN MONOTHERAPIE


Tous les 3 mois, jusqu’à progression ou pendant une durée maximale de 2 ans

Traitement d’entretien chez des patients en rechute ou réfractaires répondant à une chimiothérapie ou immunochimiothérapie d’induction

(≥ 2ème ligne)

A - I VAN OERS ET AL. [94]

OMEDIT / 27_04_09




Traitement de consolidation après induction d’une rémission

(1ère ligne) A - I MORSCHHAUSER ET AL.

[70]

WITZIG ET AL. [100]

R-IBRITUMOMAB TIUXETAN

- Rituximab 250 mg/m² J1, J8

- 90Y Ibritumomab Tiuxétan 15 MBq/kg J8

Dose totale maximale : 1200 MBq En rechute ou réfractaire, après

traitement par le rituximab (≥ 2ème ligne)

A - I WITZIG ET AL.

[103]

FLUDARABINE EN MONOTHERAPIE

Fludarabine inj 25 mg/m² J1 à J5 Tous les 28 jours



liste hors GHS

KLASA ET AL. [55]

B- PROTOCOLES DISCUTES EN RCP (DE 1er NIVEAU OU DE RECOURS)

PRESCRIPTION A DEFAUT, PAR EXCEPTION ET EN L’ABSENC E D’ALTERNATIVE THERAPEUTIQUE POUR LE PATIENT



TAM ET AL. [91]

R-FC


- Fludarabine inj 25 mg/m² J1, J2, J3

- Cyclophosphamide inj 250 mg/m² J1, J2, J3

Tous les 28 jours


B - Annexe INCa

SACCHI ET AL. [84]

R-FCM





Tous les 28 jours


B - Annexe INCa FORSTPOINTNER ET AL. [31]

COLOMBAT ET AL. [14]

GHIELMINI ET AL. [34]

HAINSWORTH ET AL. [42]

RITUXIMAB EN MONOTHERAPIE


Tous les 7 jours, pendant 4 semaines 1ère ligne B - Annexe INCa

WITZIG ET AL. [101]

OMEDIT / 27_04_09




MEY ET AL. [66]

R-DHAP








B - Protocole absent du référentiel de

l’INCa WITZIG ET AL.

[102]

R-ICE







l’INCa

PALACIOS ET AL. [76]

R-ESHAP








l’INCa


R-EPOCH





0,4 mg/m² J1, J2, J3, J4, DT max : 2 mg - Cyclophosphamide




l’INCa

JERMANN ET AL. [52]

OMEDIT / 27_04_09




R-MIV







l’INCa

VELLENGA ET AL. [97]

R-GEMOX

- Rituximab 375 mg/m² J1 - Gemcitabine 1000 mg/m² J1 - Oxaliplatine 100 mg/m² J1

Tous les 14 jours



l’INCa

EL GNAOUI ET AL. [25]





CLADRIBINE - - C - Annexe INCa -

FLUDARABINE EN MONOTHERAPIE - 1ère ligne

C - Médicament non inscrit sur la liste

hors GHS -

ALEMTUZUMAB - - C - Annexe INCa -

VINORELBINE - - C - Médicament non

inscrit sur la liste hors GHS

-

OMEDIT / 27_04_09


V- LYMPHOMES DU MANTEAU A- PROTOCOLES ENREGISTRES EN RCP



R-FC




Tous les 28 jours


A - II THOMAS ET AL. [92]

R-FCM





Tous les 28 jours


A - II FORSTPOINTNER ET AL. [31]

TEMSIROLIMUS EN MONOTHERAPIE

Cure n° 1 Temsirolimus

175 mg dose totale J1, J8, J15

Cure n° 2 et suivantes Reprise à J21 Temsirolimus

75 mg dose totale J1 Tous les 7 jours


A - I HESS ET AL. [47]


EN MONOTHERAPIE



Traitement de consolidation Cytarabine susp intrathécale

50 mg dose totale S5, S7, S9, S13 3 injections à 14 jours d’intervalle et une 4 ème 28 jours après




En curatif A - I GLANTZ ET AL.

[37]

OMEDIT / 27_04_09








15 mg dose totale

Méningite lymphomateuse En prophylaxie et en curatif


DELRIEU ET AL. [18]





LENZ ET AL. [57]

R-CHOP





- Doxorubicine 50 mg/m² J1 - Vincristine

1,4 mg/m² J1, dose totale maximale : 2 mg - Prednisone per os




1ère ligne B - Annexe INCa

SCHULZ ET AL. [86]

DE GUIBERT ET AL. [16]

1ère ligne DELARUE ET AL.

[17]

R-DHAP








B - Protocole absent du

référentiel de l’INCa

WITZIG ET AL. [102]

COIFFIER ET AL. [12] RITUXIMAB

EN MONOTHERAPIE


Tous les 7 jours


B - Annexe INCa FORAN ET AL.

[30]

OMEDIT / 27_04_09




FORSTPOINTNER ET AL. [31] RITUXIMAB

EN MONOTHERAPIE


Tous les 3 mois, jusqu’à progression ou pendant une durée maximale de 2 ans

Traitement d’entretien chez des patients en

rechute (≥ 2ème ligne)



FORSTPOINTNER ET AL. [32]

FISHER ET AL. [29] BORTEZOMIB

EN MONOTHERAPIE

Bortézomib 1,3 mg/m² J1, J4, J8, J11

Tous les 21 jours


B - Annexe INCa GOY ET AL.

[38]

R-VAD-CHLORAMINOPHENE

- Rituximab 375 mg/m² J1 - Vincristine

0,4 mg dose totale J1 à J4 - Doxorubicine 9 mg/m² J1 à J4

- Dexaméthasone per os 40 mg dose totale J1 à J4, J9 à J12, J17 à J20

- Chlorambucil 12 mg dose totale J20 à J29

Tous les 35 jours

1ère ligne



GRESSIN ET AL. [40]

R-ICE









R-ESHAP










OMEDIT / 27_04_09




R-EPOCH





0,4 mg/m² J1, J2, J3, J4 Dose totale maximale : 2 mg


Tous les 21 jours




JERMANN ET AL. [52]

R-MIV








VELLENGA ET AL. [97]






ALEMTUZUMAB - - C - Annexe INCa -

VINORELBINE - - C - Médicament


-

OMEDIT / 27_04_09


VI- LYMPHOMES DE HODGKIN A- PROTOCOLES ENREGISTRES EN RCP



ABVD

- Doxorubicine 25 mg/m² J1, J15

- Vinblastine 6 mg/m² J1, J15 - Bléomycine

10 mg/m² J1, J15 - Dacarbazine

375 mg/m² J1, J15 Tous les 28 jours


DUGGAN ET AL. [23]

VABEM

- Vindésine 1 mg/m² J1 à J5 - Doxorubicine

33 mg/m² J1 à J3 - Carmustine 140 mg/m² J3 - Etoposide

200 mg/m² J3 à J5 - Méthylprednisolone inj


En cas de réponse insuffisante sous ABVD

(1ère ligne) A - I ARAKELYAN ET AL.

[2]

BEACOPP


- Cyclophosphamide 650 mg/m² J1 - Etoposide

100 mg/m² J1, J2, J3 - Bléomycine 10 mg/m² J8 - Vincristine 1,4 mg/m² J8

Dose totale maximale : 2 mg - Procarbazine per os

100 mg/m² J1 à J7 - Prednisone per os 40 mg/m² J1 à J14 Tous les 21 jours


DIEHL ET AL. [19]

OMEDIT / 27_04_09




BEACOPP renforcé




- Bléomycine 10 mg/m² J8 - Vincristine 1,4 mg/m² J8

Dose totale maximale : 2 mg - Procarbazine per os

100 mg/m² J1 à J7 - Prednisone per os 40 mg/m² J1 à J14 Tous les 21 jours


DIEHL ET AL. [19]

DHAP








JOSTING ET AL. [53]

DEXA-BEAM

- Dexaméthasone per os 24 mg dose totale J1 à J10


- Melphalan inj 20 mg/m² J3 - Etoposide

75 mg/m² J4, J5, J6, J7 - Cytarabine

200 mg/m² J4, J5, J6, J7 Tous les 28 jours


A - I PFREUNDSCHUH ET AL. [79]

IVA 50

- Doxorubicine 50 mg/m² J1 - Ifosfamide






OMEDIT / 27_04_09




IVA 75

- Doxorubicine 75 mg/m² J1 - Ifosfamide






VINBLASTINE EN MONOTHERAPIE

Vinblastine 6 mg/m² J1

Dose totale maximale : 9 mg Tous les 7 jours



liste hors GHS

LITTLE ET AL. [59]

FERME ET AL. [27]

MINE

- Mitoguazone 500 mg/m² J1, J5

- Ifosfamide 1500 mg/m² J1 à J5

- Vinorelbine 15 mg/m² J1, J5


Tous les 28 jours



FERME ET AL. [28]





REHWALD ET AL. [81] RITUXIMAB

EN MONOTHERAPIE


Tous les 7 jours, pendant 4 semaines

Paragranulome de Poppema CD20 +

B - Annexe INCa EKSTRAND ET AL.

[24]





GEMCITABINE - BLEOMYCINE - DOXORUBICINE - VINBLASTINE

- 1ère ligne C - III -

OMEDIT / 27_04_09


VII- MYELOME MULTIPLE

A- PROTOCOLES ENREGISTRES EN RCP



BORTEZOMIB - MELPHALAN - PREDNISONE

(MPV)

Cures n° 1 à 4 - Bortézomib

1,3 mg/m² J1, J4, J8, J11, J22, J25, J29, J32 - Melphalan per os

9 mg/m² J1 à J4 - Prednisone per os


Cures n° 5 à 9 - Bortézomib

1,3 mg/m² J1, J8, J22, J29 - Melphalan per os

9 mg/m² J1 à J4 - Prednisone per os


Patients non éligibles à la chimiothérapie intensive

accompagnée d’une greffe de moelle osseuse

(1ère ligne)

A - I SAN MIGUEL ET AL. [85]

THALIDOMIDE - MELPHALAN - PREDNISONE

(MPTHAL)

- Thalidomide 200 mg/j en continu - Melphalan per os 0,25 mg/kg J1 à J4

- Prednisone per os 2 mg/kg J1 à J4

Tous les 42 jours

Patients de + de 65 ans (1ère ligne)

Myélome multiple non traité ou en cas de contre-indication

à la chimiothérapie haute dose


FACON ET AL. [26]

MELPHALAN - PREDNISONE

- Melphalan per os 0,25 mg/kg J1 à J4

- Prednisone per os 2 mg/kg J1 à J4

Tous les 42 jours

En cas de contre-indication au thalidomide (≥ 1ère ligne)


ALEXANIAN ET AL. [1]

THALIDOMIDE EN MONOTHERAPIE

Thalidomide 100 mg/j

En continu

Patients n’ayant pas obtenu de réponse complète après

autogreffe (1ère ligne)


liste hors GHS

ATTAL ET AL. [3]

VAD

- Vincristine 0,4 mg dose totale J1 à J4

- Doxorubicine 9 mg/m² J1 à J4

- Dexaméthasone per os 40 mg DT J1 à J4, J9 à J12 et J17 à J20

Tous les 28 jours



BARLOGIE ET AL. [5]

OMEDIT / 27_04_09




RICHARDSON ET AL. [82]

BORTEZOMIB EN MONOTHERAPIE

Bortézomib 1,3 mg/m² J1, J4, J8, J11

Tous les 21 jours

Après au moins un traitement antérieur, chez des patients

ayant déjà bénéficié ou inéligibles pour une greffe de

moelle osseuse (≥ 2ème ligne)

A - I

RICHARDSON ET AL. [83]

DIMOPOULOS ET AL. [20]

LENALIDOMIDE - DEXAMETHASONE

- Lénalidomide 25 mg dose totale J1 à J21 - Dexaméthasone per os

40 mg dose totale J1, J8, J15, J22 Tous les 28 jours

Patients ayant déjà reçu au moins un traitement antérieur

(≥ 2ème ligne) A - I

RAJKUMAR ET AL. [80]

BORTEZOMIB - Doxorubicine liposomale pégylée (CAELYX®)

- Bortézomib 1,3 mg/m² J1, J4, J8, J11

- CAELYX® 30 mg/m² J4

Tous les 21 jours

Patients ayant reçu au moins un traitement antérieur, qui

ont déjà subi ou sont inéligibles pour une greffe de

moelle osseuse (≥ 2ème ligne)

A - I ORLOWSKI ET AL. [75]

DIMOPOULOS ET AL. [21]

THALIDOMIDE - DEXAMETHASONE

- Thalidomide 200 mg/j en continu

- Dexaméthasone per os 40 mg dose totale J1, J2, J3, J4

Tous les 21 jours


A - Médicaments non inscrits sur la liste hors GHS PALUMBO ET AL.

[78]





BORTEZOMIB - DOXORUBICINE - DEXAMETHASONE

(PAD)

- Bortézomib 1,3 mg/m² J1, J4, J8, J11

- Doxorubicine 20 mg/m² J1, J4

- Dexaméthasone per os 40 mg dose totale J1 à J4

Tous les 28 jours




PALUMBO ET AL. [77]

OMEDIT / 27_04_09




HAROUSSEAU ET AL. [46]

JAGANNATH ET AL. [50]

BORTEZOMIB - DEXAMETHASONE

Cures n° 1 et 2 - Bortézomib

1,3 mg/m² J1, J4, J8, J11 - Dexaméthasone per os

40 mg dose totale J1 à J4 et J9 à J12 Tous les 21 jours

Cures n° 3 et 4 - Bortézomib

1,3 mg/m² J1, J4, J8, J11 - Dexaméthasone per os 40 mg dose totale J1 à J4

Tous les 21 jours

≥ 1ère ligne



JAGANNATH ET AL. [51]




LENALIDOMIDE - DEXAMETHASONE - 1ère ligne

C - Protocole absent du référentiel de

l’INCa -

OMEDIT / 27_04_09


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OMEDIT / 27_04_09


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