Which treatment regimens are being investigated for the treatment of diffuse large B-cell lymphoma (DLBCL)?

Updated: Aug 20, 2020
  • Author: Shipra Gandhi, MBBS; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

A German trial explored the safety and feasibility of dose-escalated CHOP-etoposide with 3 autologous stem cell transplantations (ASCTs) as aggressive up-front therapy in young patients with high lactate dehydrogenase (LDH) levels. [152] The investigators found the therapy to be safe and feasible, but its role is unclear. Rituximab was not used, and whether these intensive regimens are better than less intense chemotherapy plus rituximab is currently under investigation.

Antisense therapy (Bcl-2 antisense therapy) has entered clinical trials with promising results. However, its role outside of these trials has not yet been established.

In preliminary studies, the addition of bortezomib, a protease inhibitor approved for the treatment of mantle cell lymphoma and multiple myeloma, to treatment with CHOP plus rituximab (R-CHOP), yielded encouraging results. However, in a randomized phase II trial in previously untreated patients with non-germinal center B-cell–like DLBCL, the addition of bortezomib to R-CHOP did not result in significant improvement in outcome. [153]

Multicenter trials of radioimmunotherapy with ibritumomab tiuxetan (yttrium-90 [90 Y] Zevalin) and iodine-131 (131 I) tositumomab (Bexxar), CD20-targeting radiolabeled antibodies approved for use in follicular lymphomas, are also ongoing.


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