意大利博洛尼亚大学Pier Paolo Piccaluga教授访谈

　　Oncology Frontier: How can we improve the treatment strategy for elderly aggressive adult T-cell leukemia-lymphoma (ATL) patients?

　　《肿瘤瞭望》：您认为该如何改善老年侵袭性T细胞白血病/淋巴瘤患者的治疗策略？

　　Dr Piccaluga: We now have consistent data that for this disease， adult T-cell leukemia-lymphoma， which is driven by a virus， HTLV-1， intensive chemotherapy is better than conventional chemotherapy. Japanese research has shown that a combined strategy with intensified treatment is effective. New randomized trials are now ongoing combining new agents such as CCR-4 inhibitors where molecules inhibit the specific receptor on the surface of the tumor cells in these intensified regimens to see if these combinations will be better than chemotherapy alone. Preliminary results are in favor of this.

　　Piccaluga教授：目前一致认为，成人T细胞淋巴瘤是由HTLV-1病毒引起的，强化治疗比常规化疗效果更好。日本一项研究表明，联合强化治疗的疗效显著。目前正在进行一项新的随机试验，观察联合治疗是否比单纯化疗效果更好。在考察的强化治疗方案中，联合新药物CCR-4抑制剂的结果表明联合治疗比单纯化疗效果更好。CCR-4抑制剂是一种可以抑制肿瘤细胞表面的特异性受体。

　　Oncology Frontier: What are the prognostic biomarkers in patients with localized natural killer/T-cell lymphoma treated with concurrent chemoradiotherapy?

　　《肿瘤瞭望》：局限性NK/T细胞淋巴瘤患者放化疗后的预后分子生物标志物有哪些？

　　Dr Piccaluga: This is an important issue because all of us would like to have biomarkers predicting prognosis at the beginning of treatment. When we deal with localized (early-stage) disease， it is more difficult to have strong prognostic factors. An important issue is， as these tumors are associated with Epstein-Barr virus (EBV) infection， the measure of EBV load in the blood of the patient can better refine the evaluation of treatment response. So soon after treatment， other than CT scan and PEP， if you evaluate the EBV load in the blood of the patient， you can really know if the patient is likely to be cured or need further treatment.

　　Piccaluga教授：这是一个很重要的问题，因为我们希望在治疗开始时就能通过分子生物标志物来判断预后。这在我们处理局限性（早期）病灶时，则更加困难。目前我们可已通过检测患者血液中Epstein-Barr病毒载量来评估与EB病毒感染有关的肿瘤的治疗效果。这些患者一经治疗，通过检测其血液中EB病毒的载量，而不是CT扫描和PEP等，我们即可知道患者是否可以痊愈，是否还需要进一步治疗。