Potential New Standard of Care Identified for Patients With DLBCL

According to a study that looked at improving treatment for patients with diffuse large B-cell lymphoma (DLBCL), skipping radiation and receiving less chemotherapy may become the new standard of care.

"We serve this population, and tolerance to the treatment is important to them," Daniel Persky, MD, associate director for clinical investigations at the UArizona Cancer Center, principal investigator of its Lymphoma Clinical Research Team, and professor of medicine in the Division of Hematology and Oncology at the UArizona College of Medicine—Tucson, said in a press release.

The objective of the study, which was published in Journal of Clinical Oncology, was to improve treatment for patients with Stage I or II DLBCL. Historically, DLBCL can be treated with a chemotherapy combination of drugs known as R-CHOP. This combination is made up of the following: rituximab (R) plus cyclophosphamide (C), hydroxydaunomycin (H), oncovin (O) and prednisone (P). Patients receiving R-CHOP then undergo three cycles of chemotherapy followed by radiation. The other option is for patients to complete six treatment cycles without radiation.

According to the new study, radiation is not needed for every patient. The findings of the study suggest that patients should use a positron emission tomography (PET) scan after three cycles of R-CHOP. The researchers suggest that if a PET scan comes back negative, then they can continue with one additional round of R-CHOP to complete treatment.

Patients who had a positive PET scan, did not continue additional rounds of R-CHOP treatment. They underwent radiation therapy and a booster treatment where scans showed growing cancer cells, instead. Patients then received treatment with a radioimmunotherapy drug, ibritumomab tiuxetan. Of important note, this is not yet FDA approved for DLBCL,

"This is very significant for many of our patients at the UArizona Cancer Center," said Joann Sweasy, PhD, the Nancy C. and Craig M. Berge Endowed Chair and UArizona Cancer Center director. "I congratulate Dr. Persky on leading this high impact clinical research study."

"This can be the new standard of care for limited stage DLBCL patients," Dr Persky said. "Many patients can forgo radiation and receive less chemotherapy while still getting excellent results."

—Julie Gould  

Reference:

EurekAlert!. Many Non-Hodgkin's Lymphoma patients can skip radiation, collaborative study finds [press release]. https://www.eurekalert.org/pub_releases/2020-10/uoah-mnl100620.php. Published October 6, 2020. Accessed October 19, 2020.