Matthew J. Matasar, MD, Chief of Medical Oncology at Memorial Sloane Kettering Cancer Center Bergen, discusses the current landscape of diffuse large B-cell lymphoma (DLBCL).
In his presentation at the Second Annual Summit of the Americas on Immunotherapies for Hematological Malignancies, Matasar provided an overview of the many trials currently being evaluated for this patient population, including the POLARIX study (NCT03274492), the ESCALADE trial (NCT04529772) , the PHOENIX (NCT01855750), the CAVALLI trial (NCT02055820), and more.
The majority of these trials aim to improve the standard first-line treatment for these patients of rituximab (Rituxan), cyclophosphamide, doxorubicin, vincristine, prednisone (R-CHOP) for patients with DLBCL.
0:08 | There have been ongoing and significant changes in our ability to treat diffuse large B-cell lymphoma, both in patients with a new diagnosis and in patients who have suffered a relapse or refractory primary disease. With respect to our current landscape for the new diagnosis of large B-cell lymphoma, R-CHOP may now be on the verge of being replaced, at least in a subset of patients, by the POLARIX regimen.
0:32 | There is obviously work to try to develop more new front-line therapies, including the ESCALADE trial, which is trying to incorporate the new BTK inhibitor, acalabrutinib, in addition to the R-CHOP program for patients. with non-germ centric B-cell immunophenotype diffuse large B-cell lymphoma, as well as other trials examining other approaches such as including tafasitamab and lenalidomide in refractory large cell lymphoma and adding this program to the R-CHOP skeleton.
1:03 | Additionally, there has been some interesting early work on the use of immunotherapies. If recently diagnosed if started with lymphoma either for the purpose of saving slow-response patients, measured by persistence of minimal residual disease, circulating tumor cells, or tumor DNA circulating after the initial induction treatment. We now have trials in development and deployment incorporating specific antibodies targeting CD20 and CD3, in addition to chemotherapy or instead of chemotherapy for average risk or frail patients respectively.