Changes in the Treatment Landscape for Patients With DLBCL

Matthew J. Matasar, MD, chief of the Medical Oncology Service at Memorial Sloane Kettering Cancer Center Bergen, discusses the current landscape of diffuse large B-cell lymphoma (DLBCL).

Within his presentation at the second annual Summit of the Americas on Immunotherapies for Hematologic Malignancies, Matasar gave a run down of the many trials currently being evaluated for this patient population, including the POLARIX study (NCT03274492), ESCALADE trial (NCT04529772), the PHOENIX study (NCT01855750), the CAVALLI trial (NCT02055820), and more.

A majority of these trials aim to improve on the standard frontline treatment for these patients of rituximab (Rituxan), cyclophosphamide, doxorubicin, vincristine, prednisone (R-CHOP) for patients with DLBCL.

0:08 | There’s been ongoing, tremendous changes in our ability to treat diffuse large B-cell lymphoma, both in patients with a new diagnosis as well as in patients who suffered from a relapse or have primary refractory disease. In terms of our current landscape for new diagnosis of large B-cell lymphoma, R-CHOP may now be on the verge of being replaced at least in a subset of patients by the POLARIX regimen.

0:32 | There's obviously work on going to try to further develop novel first line therapies, including the ESCALADE trial, which is attempting to incorporate novel BTK inhibitor, acalabrutinib, on top of the R-CHOP program for patients with non-germinal centered B-cell immunophenotype diffuse large B cell lymphoma, as well as other trials looking at other approaches such as inclusion of tafasitamab and lenalidomide in refractory large-cell lymphoma and adding this program to the R-CHOP backbone.

1:03 | Additionally, there's been initial interesting work looking at the use of immunotherapies. In newly diagnosed if you started using lymphoma either in an attempt to salvage slowly responding patients as measured by persistence of minimal residual disease, or circulating tumor cells, or circulating tumor DNA after initial induction therapy. We now have trials that are being developed and deployed incorporating by specific antibodies targeting CD20, and CD3, in addition to chemotherapy or in lieu of chemotherapy for average risk or frail patients respectively.