Novel Therapies for Relapsed or Refractory Diffuse Large B-Cell Lymphoma
- PMID: 33202794
- PMCID: PMC7698117
- DOI: 10.3390/ijms21228553
Novel Therapies for Relapsed or Refractory Diffuse Large B-Cell Lymphoma
Abstract
The most common type of non-Hodgkin lymphoma in adults is diffuse large B-cell (DLBCL). There is a historical unmet need for more effective therapies in the 2nd and 3rd line setting. Emerging immunochemotherapies have shown activity in small studies of heavily pre-treated patients with prolonged remissions achieved in some patients. Anti-CD19 CAR (chimeric antigen receptor) T cells are potentially curative in the 3rd line and beyond setting and are under investigation in earlier lines of therapy. Antibody-drug conjugates (ADC's) such as polatuzumab vedotin targeting the pan-B-cell marker CD79b has proven effectiveness in multiply-relapsed DLBCL patients. Tafasitamab (MOR208) is an anti-CD19 monoclonal antibody producing prolonged remissions when combined with Lenalidomide (LEN) in patients who were not candidates for salvage chemotherapy or autologous stem cell transplant. Selinexor, an oral, small-molecule selective inhibitor of XPO1-mediated nuclear export (SINE), demonstrated prolonged activity against heavily-pretreated DLBCL without cumulative toxicity and is being investigated as part of an oral, chemotherapy-free regimen for relapsed aggressive lymphoma. This article reviews current strategies and novel therapies for relapsed/refractory DLBCL.
Keywords: DLBLC; Relapsed or Refractory Diffuse Large B Cell Lymphoma; chemotherapy-free regimen; immunotherapy.
Conflict of interest statement
The authors declare no conflict of interest.
References
-
- Swerdlow S.H., Campo E., Pileri S.A., Harris N.L., Stein H., Siebert R., Advani R., Ghielmini M., Salles G.A., Zelenetz A.D., et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood. 2016;127:2375–2390. doi: 10.1182/blood-2016-01-643569. - DOI - PMC - PubMed
-
- Tkacz J., Garcia J., Gitlin M., McMorrow D., Snyder S., Bonafede M., Chung K.C., Maziarz R.T. The economic burden to payers of patients with diffuse large B-cell lymphoma during the treatment period by line of therapy. Leuk. Lymphoma. 2020;61:1601–1609. doi: 10.1080/10428194.2020.1734592. - DOI - PubMed
-
- Hu S., Xu-Monette Z.Y., Tzankov A., Green T., Wu L., Balasubramanyam A., Liu W.M., Visco C., Li Y., Miranda R.N., et al. MYC/BCL2 protein coexpression contributes to the inferior survival of activated B-cell subtype of diffuse large B-cell lymphoma and demonstrates high-risk gene expression signatures: A report from The International DLBCL Rituximab-CHOP Consortium Program. Blood. 2013;121:4021–4031. doi: 10.1182/blood-2012-10-460063. - DOI - PMC - PubMed
-
- Dunleavy K., Fanale M.A., Abramson J.S., Noy A., Caimi P.F., Pittaluga S., Parekh S., Lacasce A., Hayslip J.W., Jagadeesh D., et al. Dose-adjusted EPOCH-R (etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab) in untreated aggressive diffuse large B-cell lymphoma with MYC rearrangement: A prospective, multicentre, single-arm phase 2 study. Lancet Haematol. 2018;5:e609–e617. doi: 10.1016/S2352-3026(18)30177-7. - DOI - PMC - PubMed
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources