Onkologie. 2024:18(2):109-115 | DOI: 10.36290/xon.2024.020

Novel therapeutical strategies in diffuse large B-cell lymphoma

Prokop Vodička, Marek Trněný

I. interní klinika - hematologie, 1. lékařská fakulta Univerzity Karlovy a Všeobecná fakultní nemocnice, Praha

Diffuse large B-cell lymphoma is a prototype of aggressive lymphomas. Until recently, the standard of care in the first-line setting has been the chemoimmunotherapeutic regimen R-CHOP (consisting of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) with a 60-70% chance of achieving long-term remission. The newly introduced Pola-R-CHP regimen (replacing vincristine by the antibody-drug conjugate polatuzumab vedotin) decreases the risk of DLBCL relapse and prolongs the progression-free survival of the patients. This regimen is being gradually implemented into a daily practice and is currently approved for patients with high-intermediate and high-risk disease according to IPI prognostic index. CAR (chimeric antigen receptor) T-cell therapy is approved for primary progressive disease and early relapses up to 12 months after the first-line treatment. The salvage platinum-based regimen with consolidation treatment using the high-dose chemotherapy and autologous stem cell transplantation for younger and fit patients remains the standard of care for late DLBCL relapses. The spectrum of therapeutic strategies in the third and subsequent lines of treatment is expanding with innovative treatment options, including bispecific antibodies, and other targeted therapy. Thanks to these advances, the strategy for third-line treatment is now shifting from palliative to curative intent.

Keywords: aggressive lymphomas, diffuse large B-cell lymphoma, relapsed/refractory, targeted therapy, antibody-drug conjugates.

Accepted: April 19, 2024; Published: May 3, 2024  Show citation