ASH 2024 | Retreatment with R-CHOP-like therapy in patients with late relapse of DLBCL

This was a retrospective study that looked at patients with late relapse DLBCL, so relapsing after 24 months, that got a second round of treatment of R-CHOP-like therapy. Basically what we do demonstrate is that, first of all, the rationale is that late relapse DLBCL is a completely distinct biology. We know that they share very few mutations with the original diagnosis, and it’s thought to be chemotherapy naive. So we know that the R-CHOP and R-CEOP may have a curative intent potential, and it’s also a finite duration therapy. What we did is we looked at the BC Cancer Lymphoma Database and BC Cancer Pharmacy Registry to try to identify all patients who did have the first round of R-CHOP, had a late relapse, and then were treated again with the second round of R-CHOP-like therapy. And what we did see in our results is that we’ve identified 65 patients. Most of them were older, so a median age of 77 at time of relapse. Most of them had a poor prognostic score, two-thirds were IPI three or more. And despite the poor risk features of these patients, they were able to tolerate quite well the R-CHOP-like retreatment, although some of them discontinued for intolerance or progressive disease as we went along. But we still had an overall response rate of 72% and a complete response rate of 57%. Now the time to progression, which was our first and primary outcome, was 55% at a two-year mark for the entire population. Now what gets interesting is that when we split according to the timing of relapse, those who relapse between two to five years from their initial diagnosis actually had very poor outcome with the retreatments strategy, with the TTP at 24 months of only 9%, however, those who did achieve at least, or actually relapse after, five years of their initial therapy or their initial diagnosis were able to get a two-year TTP of 68%. So I think where it gets interesting is that there’s an option of treatment of re-treating with chemoimmunotherapy these patients with the curative potential for the patients, and yeah, that’s that’s pretty much the bottom line of our retrospective study.

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