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Observational Study
. 2025 Apr;100(4):606-615.
doi: 10.1002/ajh.27630. Epub 2025 Feb 7.

Outcomes of Relapsed or Refractory Diffuse Large B-Cell Lymphoma Treated With R-GemOx: A Multicenter Cohort Study

Samuel Yamshon  1 , Jean L Koff  2 , Melissa C Larson  3 , Brad S Kahl  4 , Carla Casulo  5 , Izidore S Lossos  6 , Sara Haddadi  6 , Michele Stanchina  6 , Dai Chihara  7 , Amy Ayers  2   7 , Thomas M Habermann  8 , Yucai Wang  8 , Arushi Khurana  8 , Grzegorz S Nowakowski  8 , Tanner W Reicks  3 , Umar Farooq  9 , Brian K Link  9 , Jonathon B Cohen  2 , Peter Martin  1 , Jia Li  10 , Ashwini Shewade  10 , Connie Lee Batlevi  10 , Andrea Lo-Rossi  10 , David Fox  10 , Anthony Masaquel  10 , Yong Mun  10 , James R Cerhan  3 , Christopher R Flowers  11 , Matthew J Maurer  3   8 , Loretta J Nastoupil  7
Affiliations
Observational Study

Outcomes of Relapsed or Refractory Diffuse Large B-Cell Lymphoma Treated With R-GemOx: A Multicenter Cohort Study

Samuel Yamshon et al. Am J Hematol. 2025 Apr.

Abstract

Rituximab, gemcitabine, and oxaliplatin (R-GemOx) is a commonly used chemoimmunotherapy regimen for relapsed or refractory (R/R) diffuse large B-cell lymphoma (DLBCL), but there are limited real-world data. In a multicenter retrospective study from a cohort of eight US academic centers (LEO CReWE), we evaluated 183 patients with R/R DLBCL and high-grade B cell lymphoma treated with R-GemOx, including subgroups treated without intent for consolidation with autologous stem cell transplant (ASCT) or chimeric antigen receptor (CAR) T cell therapy (n = 100), those utilizing R-GemOx as a bridge to ASCT or CAR T (n = 83), and those aged 70 and older (n = 71). Overall response rates (ORRs) for all patients treated with R-GemOx were 45% with a complete response (CR) rate of 29%. The median event-free survival (EFS) was 2.3 months, and the median overall survival (OS) was 13.5 months. Patients receiving R-GemOx without intent for ASCT or CAR T had ORR and CR rates of 33% and 18%, respectively, with median EFS and OS of 2.0 and 9.5 months, respectively. Patients receiving R-GemOx as a bridge to ASCT or CAR T had ORR and CR rates of 57% and 36%, respectively, with median EFS and OS of 3.5 and 17.4 months, respectively. Patients receiving R-GemOx aged 70 and older had ORR and CR rates of 53% and 33%, respectively, with median EFS and OS of 2.2 and 13.9 months, respectively. These data provide a benchmark for R-GemOx in the rapidly evolving landscape of R/R DLBCL therapies.

Keywords: chemotherapy; diffuse large B‐cell lymphoma; lymphoma; real‐world data.

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Conflict of interest statement

Conflict of interest disclosure: S.Y. reports consulting fees from Bristol Meyers Squibb; reports support for attending meetings and/or travel from Bristol Meyers Squibb; reports participation on a Data Safety Monitoring Board or Advisory Board with Kite Pharma. J.L.K. reports consulting fees from BeiGene USA, AbbVie; reports research funding from Viracta Therapeutics, OncTernal Therapeutics, Atara Biotherapeutics. M.C.L. reports research funding from Genentech, Genmab. B.S.K. reports consulting fees including expert testimony from Astrazeneca, ADCT Therapeutics, Roche, Genetech, Abbvie, MEI, Celgene/BMS, Kite, BeiGene, Seattle Genetics, Lilly; reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events with Research To Practice; reports research funding with Genetech, Abbvie, BeiGene, Astra Zeneca. C.C. reports consulting fees and honoraria from Abbvie, Genentech, and BMS; reports research funding from Genmab, Gilead, and Genentech; reports leadership role within FL Cures Foundation Leadership, American Society of Hematology. I.S.L reports royalties from Stanford; reports research funding from NCI, ADC Therapeutics. S.H. reports NCI funding Project (LEO) approved by the University of Miami; reports salaried employment at the University of Miami. D.C. reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events with ONO pharmaceutical, Genmab, BeiGene. T.M.H. reports grants or contracts with The LEO Cohort Study U01 CA 195568, Roche/Genentech, GenMab, and BMS; reports participation on a Data Safety Monitoring Board or Advisory Board with Seagen, and Eli Lilly. Y.W. reports consulting fees with Eli Lilly, LOXO Oncology, TG Therapeutics, Incyte, InnoCare, Kite, Jansen, BeiGene, AbbVie, AstraZeneca, Genmab; reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events with Kite; reports research funding with Incyte, InnoCare, LOXO Oncology, Eli Lilly, MorphoSys, Novartis, Genentech, Genmab, AbbVie. G.S.N. reports consulting fees from Daiichi Sankyo, Inc., Karyopharm Therapeutics, Kite Pharma, Inc., Zai Laboratory, Kymera Therapeutics, Blueprint Medicines Corporation, Bantam Pharmaceutical, LLC, Constellation Pharmaceuticals, AbbVie Inc., ADC Therapeutics, TG Therapeutics, Inc, Fate Therapeutics, MEI Pharma, Incyte Corporation, TG Therapeutics, Inc, Zai Lab Limited, Selvita Inc, Debiopharm, Ryvu Therapeutics, Celgene Corporation, MorphoSys AG, Genentech Inc, MEI Pharma Inc, Curis, Seagen, Bristol-Myers Squibb, F Hoffmann-La Roche Limited. T.W.R. reports research project funding from Genentech, a Roche company for LEO at Mayo Clinic; reports funding of research projects for MER/LEO with BMS, Genmab. U.F. reports consulting fees from Morphosys; reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational event with Kite Pharma and Caribou Pharma. B.K.L reports consulting fees from Genentech/Roche, MEI Pharma Inc; reports payment for expert testimony with Amgen; reports research funding with Genentech/Roche, Genmab, Celgene, Astra Zeneca. J.B.C. reports current employment with Emory University in Atlanta, GA; reports a consulting or advisory role within BeiGene, Lilly, Astra Zeneca, Janssen, Genentech, Kite/Gilead; reports research funding from Genentech, Celgene, Novartis, Takeda, Astra Zeneca, Loxo/Lilly, Lam Therapuetics, BioInvent. P.M. reports consulting fees from Abbvie, AstraZeneca, Beigene, BMS, Daiichi, Genentech, Janssen, Pepromene, Merck. J.L. reports all support for the present manuscript with Genentech, Inc.; reports stock or stock options with F. Hoffmann-La Roche Ltd. A.S. reports current employment and current equity holder with F. Hoffmann-La Roche Ltd. C.L.B. reports consulting fees with BMS, Seattle Genetics, Kite, Karyopharm, TG Therapeutics, ADC Therapeutics, Abbvie, Genentech, Treeline Bioscience; reports stock or stock options with Roche, Regeneron, Moderna; reports research funding with Epizyme, Autolus, Roche, Vincerx. A.L.R. reports research funding and medical writing support from Genentech, a Roche company; reports personal stock or stock options with Roche; reports salaried employment of Genentech, a Roche company. D.F. reports research funding and medical writing support with Genentech, a Roche company; reports personal stock or stock options with Roche; reports salaried employment of Genentech, a Roche company. A.M. reports all support for the present manuscript with Genentech, Inc.; reports stock or stock options with F. Hoffmann-La Roche Ltd. Y.M. reports stock or stock options with Genentech/Roche. J.R.C. reports all support for the present manuscript with Genentech; reports Mayo Clinic consulting fees with BMS – Connect Lymphoma Scientific Advisory Board, reports personal consulting fees with Protagonist Therapeutics SMC; reports research funding with Genmab, BMS. C.R.F. reports consulting fees from Bayer, Gilead, Spectrum Pharmaceuticals, AbbVie, Celgene, Denovo Biopharma, BeiGene, Karyopharm Therapeutics, Pharmacyclics/Janssen, Genentech/Roche, Epizyme, Genmab, SeaGen, Foresight Diagnostics, BMS/Celgene, Curio Science, AstraZeneca, MorphoSys; reports stock or stock options with Foresight Diagnostics, N Power; reports research funding from Acerta Pharma, Janssen Oncology, Gilead Sciences, Celgene, TG Therapeutics, Genentech/Roche, Pharmacyclics, AbbVie, Millennium, Alimera Sciences, Xencor, 4D Pharma, Adaptimmune, Amgen, Bayer, Cellectis, EMD Serono, Guardant Health, Iovance Biotherapeutics, Kite/Gilead, MorphoSys, Nektar, Novartis, Pfizer, Sanofi, Takeda, ZIOPHARM Oncology. M.J.M reports consulting fees with AstraZeneca, BMS; reports research funding from Genmab, Roche/Genentech, BMS. L.J.N. reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events with Abbvie, AstraZebeca, BMS, Caribou Biosciences, Daiichi Sankyo, Genentech/Roche, Gilead/Kite, Genmab, Incyte, Ipsen, Janssen, Merck, Novartis, Regeneron, Takeda; reports research funding with BMS, Caribou Biosciences, Daiichi Sankyo, Genentech, Gilead/Kite, Genmab, Janssen, Ipsen, Merck, Novartis, Takeda; reports DSMC with Genentech/Roche, Takeda. The remaining authors declare no competing financial interests.

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