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Review
. 2018 Nov 30;2018(1):75-82.
doi: 10.1182/asheducation-2018.1.75.

Novel therapies for relapsed/refractory aggressive lymphomas

Jonathon B Cohen  1
Affiliations
Review

Novel therapies for relapsed/refractory aggressive lymphomas

Jonathon B Cohen. Hematology Am Soc Hematol Educ Program. .

Abstract

Most patients with aggressive non-Hodgkin lymphoma will be cured with initial chemoimmunotherapy; however, most patients with relapsed disease will not be cured and will die as a result of their disease. In these cases, continued treatment with conventional chemotherapy is typically not of benefit and can contribute to significant toxicities and decreased quality of life for patients. Fortunately, a number of therapies are currently available or under investigation for this group of patients, ranging from oral tyrosine kinase inhibitors targeting multiple pathways within the malignant cells to adoptive cellular therapies that harness the patient's immune system to fight disease. Additionally, many agents that are modestly effective as monotherapies can be safely combined with additional novel and conventional therapies to improve response rates and duration. Chimeric antigen receptor T cells are among the most promising group of therapies and provide the potential for cure for patients with relapsed/refractory lymphoma. In this chapter, we will review the currently available novel treatments as well as those still under investigation and discuss the most appropriate approach to patients with relapsed/refractory aggressive lymphoma. We will highlight the challenges associated with these therapies, as well as potential toxicities, and the need for additional clinical trials evaluating combinations and newer treatments.

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Conflict of interest statement

Conflict-of-interest disclosure: J.B.C. is on the board of directors or an advisory committee for Genentech, AbbVie, Janssen, Seattle Genetics, and BioInvent and has received research grants from American Society of Hematology and the Lymphoma Research Foundation and research funding from LAM, Bristol-Myers Squibb, Novartis, Seattle Genetics, and Takeda.

Figures

Figure 1.
Figure 1.
Selected therapies that are available or under investigation for management of aggressive lymphoma. axi-cel, axicabtagene ciloleucel; BiTE, bispecific T-cell engager; CAR-T, chimeric antigen receptor T cells; mTOR, mammalian target of rapamycin; PI3K, phosphatidylinositol-3 kinase; syk, spleen tyrosine kinase.
Figure 2.
Figure 2.
My approach to patients with relapsed/refractory aggressive B-cell NHL. auto, autologous; BMT, bone marrow transplantation; chemo, chemotherapy.
See this image and copyright information in PMC

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