DLBCL

Lymphoma

Diffuse large B-cell lymphoma is the most common adult non-Hodgkin lymphoma, accounting for about a third of all cases. The World Health Organization classification recognizes over 15 subtypes of DLBCL, based on the primary tumor site, specific genetic alterations, or association with specific viruses.

Polatuzumab vedotin in combination with&nbsp;bendamustine and rituximab has been granted an accelerated approval from the FDA for the&nbsp;treatment of patients with relapsed/refractory diffuse large B-cell lymphoma.<br /> &nbsp;

Copanlisib has been granted with a breakthrough therapy designation from the FDA for the&nbsp;treatment of adult patients with relapsed marginal zone lymphoma who have received at least 2 prior therapies.

Combining&nbsp;lenalidomide with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone did not improve progression-free survival compared with placebo and R-CHOP as a frontline therapy in patients with activated B-cell-type diffuse large B-cell lymphoma, missing the primary endpoint of the phase III ROBUST trial.

David Miklos, MD, discusses his advice for community oncologists treating patients with diffuse large B-cell lymphoma.

Paul J. Shaughnessy, MD,&nbsp;discusses updates in stem cell mobilization and transplant for DLBCL, including the potential for CAR T-cell therapy to supplant autologous stem cell transplant.

A novel Fc-enhanced CD19-targeted antibody, MOR208, is generating interest for the treatment of patients with relapsed or refractory diffuse large B-cell lymphoma who are not eligible for high-dose chemotherapy and autologous stem cell transplantation and is making its way toward a future regulatory filing.

Researchers have defined a clinically and biologically distinct subgroup of tumors within germinal center B-cell&ndash;like diffuse large B-cell lymphoma characterized by a gene expression signature of high-grade B-cell lymphoma with&nbsp;<em>MYC&nbsp;</em>and&nbsp;<em>BCL2&nbsp;</em>and/or&nbsp;<em>BCL6&nbsp;</em>rearrangements, according to a study published in the&nbsp;<em>Journal of Clinical Oncology</em>.

In an interview with&nbsp;<em>Targeted Oncology&nbsp;</em>during the 2018 ASH Annual Meeting, Elizabeth Lihua Budde, MD, PhD, discussed the results seen from this trial for patients with FL and DLBCL. She shared plans for the next steps and how this treatment may impact the patient population.

Based on data from the phase III AUGMENT trial, a supplemental new drug application for the&nbsp;R²&nbsp;regimen of lenalidomide plus rituximab has been granted a priority review designation by the FDA&nbsp;as a therapy for patients with previously treated follicular lymphoma and marginal zone lymphoma.

Reduced-dose rituximab combined with cyclophosphamide, doxorubicin, vincristine, and prednisolone had a similar complete response rate, progression-free survival, and overall survival compared with standard-dose R-CHOP or previous dose-adjusted R-CHOP chemotherapy in elderly patients with diffuse large B-cell lymphoma.

Polatuzumab vedotin, an&nbsp;antibody-drug conjugate that has demonstrated a 40% complete response rate in patients with&nbsp;relapsed/refractory diffuse large B-cell lymphoma, has been granted a&nbsp;priority review designation by the FDA in combination with&nbsp;bendamustine and rituximab for the treatment of these patients,&nbsp;according to Genentech, the manufacturer of the agent.

Brian T. Hill, MD, PhD, discusses the safety findings from the ZUMA-1 trial investigating axicabtagene ciloleucel (KTE-C19, axi-cel) in patients with diffuse large B-cell lymphoma.

Updated data from the JULIET trial,&nbsp;which were presented at the 2018 ASH Annual Meeting, underscore the impact of&nbsp;tisagenlecleucel for patients with diffuse large B-cell lymphoma, said&nbsp;Richard T. Maziarz, MD, the trial&#39;s lead investigator.

Brian T. Hill, MD, PhD, discusses data from a retrospective trial looking at the use of axicabtagene ciloleucel (axi-cel; Yescarta) in patients with diffuse large B-cell lymphoma.

Anas Younes, MD,&nbsp;discusses findings from a subset analysis from the PHOENIX trial in patients with DLBCL. He also highlights another trial investigating R-CHOP plus a PD-L1 inhibitor in this patient population.

Brian T. Hill, MD, PhD,&nbsp;discusses real-world findings with axi-cel in patients with DLBCL and how these findings can be used to inform practice.

The dose-adjusted EPOCH-R chemotherapy regimen induced either a complete or partial response in 87% of patients with aggressive B-cell lymphomas with an <em>MYC</em> rearrangement, a population that has had historically poor prognoses with rituximab plus R-CHOP.

During a <em>Targeted Oncology</em> live case-based peer perspectives presentation, Jonathon B. Cohen, MD, MS, recently discussed the treatment considerations and decisions he makes when treating patients with classical Hodgkin Lymphoma

Viola Poeschel, MD, discusses the results for the phase III FLYER trial in which the standard 6 cycles of R-CHOP were compared to a reduced 4 cycles of R-CHOP in patients with diffuse large B-cell lymphoma

Viola Poeschel, MD,&nbsp;discusses findings from the phase III FLYER trial and how they will impact the treatment landscape for younger patients with favorable-prognosis DLBCL.<br /> &nbsp;

According to findings from the&nbsp;phase IIb SADAL study, selinexor demonstrated deep and durable responses in patients with&nbsp;relapsed/refractory diffuse large B-cell lymphoma who are not candidates for autologous stem cell transplantation.

In findings reported during the 2018 ASH Annual Meeting,&nbsp;brentuximab vedotin with conventional chemotherapy significantly improved&nbsp;progression-free survival compared with standard therapy for nonpediatric patients&nbsp;with stage III/IV Hodgkin lymphoma.

According to findings from the phase III ECHELON-2 trial presented at the 2018 ASH Annual Meeting, the use of brentuximab vedotin (Adcetris) in combination with chemotherapy demonstrated a clinically meaningful improvement in progression-free survival and overall survival in patients with CD30-expressing peripheral T-cell lymphoma. These data were also published online in&nbsp;<em>Lancet Oncology</em>.

A look back at all the FDA news that happened in the month of November 2018, including several new approvals, priority reviews, a fast track designation, and an accelerated approval, across a variety of cancer types.