The standard of care for DLBCL and double-hit lymphoma

Laurie Sehn, MD of British Columbia Cancer Agency, Vancouver, Canada discusses the standard of care for patients with diffuse large B-cell lymphoma (DLBCL). For patients with advanced stage DLBCL, the standard is R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone). According to Dr Sehn, for a large proportion of patients this is adequate with cure rates of around 60-65%. The challenging group are those patients who aren’t cured as their chances of being cured with salvage therapy are very low. Therefore, improving frontline therapy is very important. Dr Sehn explains that in her clinic, they don’t treat patients who have so-called double-hit lymphoma (with a dual translocation of MYC and BCL2) with R-CHOP upfront because it is clear that they have a poor prognosis if they receive R-CHOP. They are treated with dose-adjusted EPOC-R (etoposide, doxorubicin, and cyclophosphamide with vincristine and prednisone) but it is not clear yet if the outcome for those patients will be better on this treatment.
Recorded at the 2016 International Workshop on Non-Hodgkin Lymphoma (iwNHL) meeting held in San Diego, CA.

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