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ASH 2024 | The current landscape of frontline DLBCL trials
Gilles Salles, MD, PhD, Memorial Sloan Kettering Cancer Center, New York, NY, comments on the evolving landscape of frontline diffuse large B-cell lymphoma (DLBCL) trials. Prof. Salles highlights the rapid progress in the field, with ongoing trials assessing novel combinations, including acalabrutinib and bispecific antibodies, as well as CAR T-cell therapy. He emphasizes the need to carefully evaluate the benefits and constraints of these emerging treatments to improve outcomes for patients with DLBCL. This interview took place at the 66th ASH Annual Meeting and Exposition, held in San Diego, CA.
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Transcript (AI-generated)
The landscape of first-line trial in patients with newly diagnosed large B-cell lymphoma is evolving very rapidly. So while R-CHOP has been the standard of care for more than 20 years, POLARIX was the first study showing a benefit over R-CHOP by the addition of polatuzumab vedotin replacing vincristine. But the field is continuing to move and there are a couple of trials which have been accomplished assessing different hypotheses which are currently running...
The landscape of first-line trial in patients with newly diagnosed large B-cell lymphoma is evolving very rapidly. So while R-CHOP has been the standard of care for more than 20 years, POLARIX was the first study showing a benefit over R-CHOP by the addition of polatuzumab vedotin replacing vincristine. But the field is continuing to move and there are a couple of trials which have been accomplished assessing different hypotheses which are currently running. Probably the one that we will hear in the next one or two years, the one targeting in patients with a non-germinal center B-cell lymphoma, more specifically in ABC, the introduction of acalabrutinib with R-CHOP, which was basically derived from the trial assessing ibrutinib. This has shown a benefit in younger patients, but with some toxicity and others. And we look forward to listening to this result of the targeted therapy agent. In terms of immune-based therapies, there are a couple of trials. One was addressing R-CHOP versus R-CHOP plus the anti-CD19 tafasitamab and lenalidomide. And two very important trials are well underway comparing R-CHOP versus R-CHOP plus epcoritamab or R-CHP-Pola, the POLARIX better arm with R-CHP-Pola and glofitamab. There will be probably a third trial with the third bispecific antibody or odrenextamab. So three trials in the first line setting assessing the role of the bispecific antibody in combination to immunochemotherapy. And finally, there is ZUMA-23, which attempts to initiate early treatment in high-risk patients with CAR T-cell. So this is for younger patients and fit patients. And obviously, we’ll have to discuss what’s best for patients, what will be the trial showing a benefit, what’s also constraints and side effects and how will the field evolve. So I think it’s a fascinating area, many studies, many progress and we hope that we can continue to improve the outcome in diffuse large B-cell lymphoma with all these studies which results will be clearly assessed and compared in the future. Thank you for your attention.
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