Chiappella Annalisa, Santambrogio Elisa, Castellino Alessia, Nicolosi Maura, Vitolo Umberto
a Città della Salute e della Scienza Hospital and University , Hematology , Turin , Italy.
Expert Rev Hematol. 2017 Aug;10(8):697-705. doi: 10.1080/17474086.2017.1350164. Epub 2017 Jul 14.
Diffuse Large B-cell Lymphoma (DLBCL) is the most common aggressive non-Hodgkin lymphoma (NHL), with an incidence in Europe of 3.8/100.000/year. A multi-drugs chemoimmunotherapy regimen, containing rituximab, cyclophosphamide, vincristine, doxorubicin and prednisone (R-CHOP) administrated every 21 days, is the standard therapy for DLBCL patients. The discovery of several biological features of DLBCL has encouraged the introduction of novel drugs in the treatment. Areas covered: In this article, the use of standard therapies will be reviewed and will be investigated adoption of novel drugs such as Bortezomib, Bruton's tyrosine kinase, IMiDs, Venetoclax, mTOR inhibitors and other biological agents. Expert commentary: A better knowledge of the biology of DLBCL is mandatory to tailor treatment and to ameliorate the poor prognosis of DLBCL. The addition of novel drugs to standard RCHOP should represent a modern approach in the treatment of DLBCL. Ibrutinib and lenalidomide showed important results in DLBCL and the integration of these drugs in first line treatment is under investigation. Despite encouraging results using novel drugs in the setting of relapsed/refractory DLBCL, the rate of failures still remains at 40%; for these reason, continued participation in clinical trials should be encouraged.
弥漫性大B细胞淋巴瘤（DLBCL）是最常见的侵袭性非霍奇金淋巴瘤（NHL），在欧洲的发病率为每年3.8/100,000。每21天进行一次包含利妥昔单抗、环磷酰胺、长春新碱、多柔比星和泼尼松（R-CHOP）的多药化疗免疫治疗方案是DLBCL患者的标准治疗方法。DLBCL若干生物学特征的发现促使了新型药物在治疗中的应用。涵盖领域：在本文中，将对标准疗法的使用进行综述，并研究新型药物如硼替佐米、布鲁顿酪氨酸激酶、免疫调节药物（IMiDs）、维奈克拉、mTOR抑制剂及其他生物制剂的采用情况。专家评论：深入了解DLBCL生物学特性对于定制治疗方案及改善DLBCL的不良预后至关重要。在标准RCHOP方案中添加新型药物应是治疗DLBCL的现代方法。伊布替尼和来那度胺在DLBCL中显示出重要疗效，目前正在研究将这些药物纳入一线治疗。尽管在复发/难治性DLBCL中使用新型药物取得了令人鼓舞的结果，但失败率仍保持在40%；因此，应鼓励持续参与临床试验。
