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Review
. 2020 Dec 14;13(1):175.
doi: 10.1186/s13045-020-01011-z.

New agents and regimens for diffuse large B cell lymphoma

Liang Wang  1   2 , Lin-Rong Li  3 , Ken H Young  4
Affiliations
Review

New agents and regimens for diffuse large B cell lymphoma

Liang Wang et al. J Hematol Oncol. .

Abstract

As a widely recognized standard regimen, R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone) is able to cure two-thirds patients with diffuse large B cell lymphoma (DLBCL), and the remaining patients suffer from refractory or relapsed disease due to resistance to R-CHOP and fare poorly. Unsatisfied outcomes for those relapsed/refractory patients prompted efforts to discover new treatment approaches for DLBCL, including chimeric antigen receptor T cells, bispecific T cell engagers, immunomodulatory drugs, immune checkpoint inhibitors, monoclonal antibodies, antibody-drug conjugates, molecular pathway inhibitors, and epigenetic-modifying drugs. Herein, up-to-date data about the most promising treatment approaches for DLBCL are recapitulated, and novel genetic classification systems are introduced to guide individualized treatment for DLBCL.

Keywords: Chemoresistance; Chimeric antigen receptor T cells; Diffuse large B cell lymphoma; Genetic classification; Immunotherapy; Novel agents.

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Conflict of interest statement

All authors declare no conflicts of interest.

Figures

Fig. 1
Fig. 1
Novel agents and strategies targeting DLBCL cell surface antigens. mAb monoclonal antibody, ADC antibody–drug conjugate, BiTE bispecific T cell engager, CAR chimeric antigen receptor, NK natural killer, PD-1 programmed cell death protein 1
Fig. 2
Fig. 2
Illustration of antitumor activities of various immunotherapies and potential resistance in DLBCL
Fig. 3
Fig. 3
Established and emerging immune checkpoint targets in DLBCL and corresponding blocking monoclonal antibodies as immune checkpoint inhibitors
Fig. 4
Fig. 4
Novel agents targeting molecular signaling pathways and epigenetic regulations. Distinct molecular aberrations classify DLBCL into different molecular subtypes and indicate individualized treatments, including BCR signaling pathways, BCL-2, JAK/STAT3 pathways, VEGFR, PI3K/Akt/mTOR pathways, NF‐κB signaling pathways, as well as epigenetic regulators, such as HDAC, EZH2, and BET
Fig. 5
Fig. 5
Recommended treatment for DLBCL. PET positron emission tomography and computed tomography, SCR stem cell rescue, ISRT involved site radiotherapy, CAR chimeric antigen receptor, HCT stem cell transplantation, Pola + BR polatuzumab vedotin combined with bendamustine and rituximab
See this image and copyright information in PMC

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