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ASCO 2026 | The rationale for exploring BTK inhibition in specific molecular subtypes of DLBCL
Manali Kamdar, MD, University of Colorado Cancer Center, Denver, CO, discusses the molecular heterogeneity of diffuse large B-cell lymphoma (DLBCL), highlighting that the disease is no longer considered a single entity, but rather comprises distinct subtypes. Dr Kamdar notes that non-germinal center subtypes, such as C5 and MCD, may be particularly responsive to BTK inhibition, providing a rationale for targeting BTK in these contexts. This interview took place during the 2026 American Society of Clinical Oncology (ASCO) Meeting in Chicago, IL.
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Transcript
So, you know, previously we used to treat diffuse large B-cell lymphoma as one disease. And I think over a period of a decade, we now know that it’s not just one disease. Initially, it came in the form of an IHC analysis and gene expression profiling that kind of identified DLBCL into either something called germinal center or non-germinal center with IHC. With gene expression profiling, it got differentiated further into germinal center and ABC...
So, you know, previously we used to treat diffuse large B-cell lymphoma as one disease. And I think over a period of a decade, we now know that it’s not just one disease. Initially, it came in the form of an IHC analysis and gene expression profiling that kind of identified DLBCL into either something called germinal center or non-germinal center with IHC. With gene expression profiling, it got differentiated further into germinal center and ABC. We now also know that this is not all that is DLBCL, and we now have molecular profiling that tells us that it’s actually divided into five different types. And each of these types is actually triggered by a targeted pathway that has the potential to get inhibited by therapeutics. So this is where I do believe that there is a role of BTK inhibition. For example, we have multiple data sets that have shown that non-GC subtypes actually respond quite well to BTK inhibition. When it comes to molecular profiling, the C5 and the MCD subtypes have a signal which tells us that BTK inhibition is very likely going to be very effective. So I do believe that there is a role to explore BTK inhibition in diffuse large B-cell lymphoma, especially in the non-GC and with regards to the molecular profiling in the C5 and the MCD subtypes.
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