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Diffuse Large B-Cell Lymphoma (DLBCL): Early Patient Management and Emerging Treatment Options
Diffuse large B-cell lymphoma (DLBCL) represents a curable disease with a 60–70% chance of cure with current R-CHOP chemoimmunotherapy. However, 30–40% of patients are refractory or relapsing. Many attempts failed to improve the outcome of DLBCL patients, including the intensification of R-CHOP regi...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Dove
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9739046/ https://www.ncbi.nlm.nih.gov/pubmed/36510607 http://dx.doi.org/10.2147/OTT.S326632 |
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author | Vodicka, Prokop Klener, Pavel Trneny, Marek |
author_facet | Vodicka, Prokop Klener, Pavel Trneny, Marek |
author_sort | Vodicka, Prokop |
collection | PubMed |
description | Diffuse large B-cell lymphoma (DLBCL) represents a curable disease with a 60–70% chance of cure with current R-CHOP chemoimmunotherapy. However, 30–40% of patients are refractory or relapsing. Many attempts failed to improve the outcome of DLBCL patients, including the intensification of R-CHOP regimen, consolidation, or maintenance therapy since the introduction of R-CHOP in 2000. Better understanding of both molecular biology of lymphoma cells and the tumor microenvironment raised the hope for future improvement of DLBCL patients’ survival. Novel molecular findings have initiated clinical trials exploring targeted therapy based on driver genetic alterations with an intent to improve survival of high-risk subsets of patients. But the preliminary results remain ambiguous. The approach “agnostic” to specific molecular alterations of lymphoma cell includes antibody-drug conjugates (especially polatuzumab vedotin), immunotherapy comprising different antibodies with immunomodulatory effect (tafasitamab, lenalidomide), and T-cell engaging therapy (bispecific antibodies, early use of CAR T-cell). This approach could increase the cure rates and change the current therapeutic paradigm. However, better prognostic stratification, smarter designs of clinical trials, modification of endpoints including the use of ctDNA are needed. This review covers the complexity of DLBCL management. |
format | Online Article Text |
id | pubmed-9739046 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Dove |
record_format | MEDLINE/PubMed |
spelling | pubmed-97390462022-12-11 Diffuse Large B-Cell Lymphoma (DLBCL): Early Patient Management and Emerging Treatment Options Vodicka, Prokop Klener, Pavel Trneny, Marek Onco Targets Ther Review Diffuse large B-cell lymphoma (DLBCL) represents a curable disease with a 60–70% chance of cure with current R-CHOP chemoimmunotherapy. However, 30–40% of patients are refractory or relapsing. Many attempts failed to improve the outcome of DLBCL patients, including the intensification of R-CHOP regimen, consolidation, or maintenance therapy since the introduction of R-CHOP in 2000. Better understanding of both molecular biology of lymphoma cells and the tumor microenvironment raised the hope for future improvement of DLBCL patients’ survival. Novel molecular findings have initiated clinical trials exploring targeted therapy based on driver genetic alterations with an intent to improve survival of high-risk subsets of patients. But the preliminary results remain ambiguous. The approach “agnostic” to specific molecular alterations of lymphoma cell includes antibody-drug conjugates (especially polatuzumab vedotin), immunotherapy comprising different antibodies with immunomodulatory effect (tafasitamab, lenalidomide), and T-cell engaging therapy (bispecific antibodies, early use of CAR T-cell). This approach could increase the cure rates and change the current therapeutic paradigm. However, better prognostic stratification, smarter designs of clinical trials, modification of endpoints including the use of ctDNA are needed. This review covers the complexity of DLBCL management. Dove 2022-12-06 /pmc/articles/PMC9739046/ /pubmed/36510607 http://dx.doi.org/10.2147/OTT.S326632 Text en © 2022 Vodicka et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). |
spellingShingle | Review Vodicka, Prokop Klener, Pavel Trneny, Marek Diffuse Large B-Cell Lymphoma (DLBCL): Early Patient Management and Emerging Treatment Options |
title | Diffuse Large B-Cell Lymphoma (DLBCL): Early Patient Management and Emerging Treatment Options |
title_full | Diffuse Large B-Cell Lymphoma (DLBCL): Early Patient Management and Emerging Treatment Options |
title_fullStr | Diffuse Large B-Cell Lymphoma (DLBCL): Early Patient Management and Emerging Treatment Options |
title_full_unstemmed | Diffuse Large B-Cell Lymphoma (DLBCL): Early Patient Management and Emerging Treatment Options |
title_short | Diffuse Large B-Cell Lymphoma (DLBCL): Early Patient Management and Emerging Treatment Options |
title_sort | diffuse large b-cell lymphoma (dlbcl): early patient management and emerging treatment options |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9739046/ https://www.ncbi.nlm.nih.gov/pubmed/36510607 http://dx.doi.org/10.2147/OTT.S326632 |
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