Current options and future perspectives in the treatment of patients with relapsed/refractory diffuse large B-cell lymphoma

• Published in: Therapeutic advances in hematology Vol. 13; p. 20406207221103321
• Main Authors: Frontzek, Fabian, Karsten, Imke, Schmitz, Norbert, Lenz, Georg
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.06.2022; Sage Publications Ltd; SAGE Publishing
• Subjects: Chemotherapy; Immunotherapy; Lymphoma; Monoclonal antibodies; Review; Stem cell transplantation; Targeted cancer therapy; Transplants & implants; ADC; DLBCL; targeted therapies; CAR T-cells; bispecific antibodies; ASCT; monoclonal antibodies
• ISSN: 2040-6207; 2040-6215
• DOI: 10.1177/20406207221103321

Diffuse large B-cell lymphoma (DLBCL) represents the most common subtype of aggressive lymphoma. Depending on individual risk factors, roughly 60–65% of patients can be cured by chemoimmunotherapy with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). However, patients with primary refractory disease or relapse (R/R) after an initial response are still characterized by poor outcome. Until now, transplant-eligible R/R DLBCL patients are treated with intensive salvage regimens followed by high-dose chemotherapy and autologous stem cell transplantation (ASCT) which, however, only cures a limited number of patients. It is most likely that in patients with early relapse after chemoimmunotherapy, chimeric antigen receptor (CAR) T-cells will replace high-dose chemotherapy and ASCT. So far, transplant-ineligible patients have mostly been treated in palliative intent. Recently, a plethora of novel agents comprising new monoclonal antibodies, antibody drug conjugates (ADC), bispecific antibodies, and CAR T-cells have emerged and have significantly improved outcome of patients with R/R DLBCL. In this review, we summarize our current knowledge on the usage of novel drugs and approaches for the treatment of patients with R/R DLBCL.