Yamaguchi Motoko
Department of Hematological Malignancies, Mie University Graduate School of Medicine.
Rinsho Ketsueki. 2022;63(9):1126-1134. doi: 10.11406/rinketsu.63.1126.
R-CHOP therapy (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) has been used as the standard treatment regimen for patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL), since the introduction of rituximab in the early 2000s. Recently, polatuzumab vedotin and anti-CD19 chimeric antigen receptor T-cell (CAR-T) therapy have been introduced as potential treatment options for relapsed or refractory DLBCL. The effectiveness of polatuzumab vedotin, rituximab, cyclophosphamide, doxorubicin, and prednisone for newly diagnosed CD20-positive DLBCL, except for the low-risk group of the international prognostic index, was reported in 2022. Bispecific antibodies such as epcoritamab, mosunetuzumab, and glofitamab, anti-CD19 antibody drug tafasitamab combined with lenalidomide, CD19 antibody drug conjugate loncastuximab tesirine, oral selective inhibitor of nuclear export selinexor, and several new agents have been investigated for DLBCL. For non-germinal center B-cell type DLBCL, R-CHOP combined with acalabrutinib is being evaluated. This review summarizes the current standard of care for DLBCL and outlines the recently introduced therapeutic agents or those that are under development in Japan.
自21世纪初引入利妥昔单抗以来，R-CHOP疗法（利妥昔单抗、环磷酰胺、阿霉素、长春新碱和泼尼松）一直被用作新诊断的弥漫性大B细胞淋巴瘤（DLBCL）患者的标准治疗方案。最近，泊洛妥珠单抗和抗CD19嵌合抗原受体T细胞（CAR-T）疗法已被引入，作为复发或难治性DLBCL的潜在治疗选择。2022年报道了泊洛妥珠单抗、利妥昔单抗、环磷酰胺、阿霉素和泼尼松对新诊断的CD20阳性DLBCL（国际预后指数低风险组除外）的有效性。双特异性抗体如依泊妥单抗、莫苏奈单抗和格洛菲单抗、抗CD19抗体药物tafasitamab联合来那度胺、CD19抗体药物偶联物loncastuximab tesirine、核输出口服选择性抑制剂塞利尼索以及几种新药已针对DLBCL进行了研究。对于非生发中心B细胞型DLBCL，正在评估R-CHOP联合阿卡替尼的疗效。本综述总结了DLBCL的当前护理标准，并概述了日本最近引入的治疗药物或正在研发的药物。
