New Options for DLBCL Treatment Will Likely Lead to Improved Outcomes

Although regimens such as rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) cure nearly 60% of patients with diffuse large B-cell lymphoma (DLBCL), many patients who do not respond to or relapse after initial therapy succumb to their disease. Consequently, more effective and noncytotoxic therapies are needed. 

In a new review article published online in Blood Cancer Journal, experts from the Lymphoma Research Foundation, Mayo Clinic Foundation, and Memorial Sloan-Kettering Cancer Center provide an in-depth review of new therapies recently approved by the US Food & Drug Administration for the treatment of patients with DLBCL: (1) the anti-CD79b antibody drug conjugate polatuzumab vedotin (Pola) with bendamustine and rituximab (Pola-BR); (2) the oral nuclear transport (XPO1) inhibitor selinexor; and (3) the combination of the anti-CD19 monoclonal antibody tafasitamab with the immunomodulatory agent lenalidomide. 

According to the piece, bispecific antibodies and antibody drug conjugates, as well as more chimeric antigen receptor T cell (CAR-T) products, are also in development.

“Having an increasing number of active therapies for DLBCL raises a number of issues,” the authors pointed out. “First is how best to sequence them.”

As research continues to investigate the sequencing and timing of various regimens for different types of patients, the identification of biomarkers to better match patients to appropriate therapies is crucial, the authors advised. 

“The greatest progress will result from the development of rational combinations with improved efficacy and a favorable safety profile,” they wrote. “…Such novel chemo-free approaches will certainly lead to improved outcomes for patients with DLBCL and other histologies of B-cell lymphomas.” 

—Jolynn Tumolo

Reference:

Cheson BD, Nowakowski G, Salles G. Diffuse large B-cell lymphoma: new targets and novel therapies. Blood Cancer J. 2021;11(4):68. Published 2021 Apr 5. doi:10.1038/s41408-021-00456-w