Davis James A, Shockley Abigail, Herbst Amanda, Hendrickson Lindsey
Medical University of South Carolina, Charleston, South Carolina.
J Adv Pract Oncol. 2023 Jan;14(1):67-72. doi: 10.6004/jadpro.2023.14.1.6. Epub 2023 Feb 1.
Diffuse large B-cell lymphoma (DLBCL) is the most common type of aggressive non-Hodgkin lymphoma in the US. For nearly 2 decades, standard front-line treatment has consisted of chemoimmunotherapy with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). Numerous trials have unsuccessfully attempted to achieve better outcomes in these patients. Recently, the results of the phase III POLARIX trial were published. This study randomized newly diagnosed DLBCL patients to receive polatuzumab vedotin in combination with rituximab, cyclophosphamide, doxorubicin, and prednisone (pola-R-CHP) or standard-of-care R-CHOP. The POLARIX trial demonstrated 2-year progression-free survival of 76.7% for pola-R-CHP compared with 70.2% for R-CHOP with comparable safety profiles between the two arms. Based on these results, a new standard of care may be emerging in patients with DLBCL. This article provides a practical approach to managing a newly diagnosed patient with DLBCL.
弥漫性大B细胞淋巴瘤（DLBCL）是美国最常见的侵袭性非霍奇金淋巴瘤类型。近20年来，标准的一线治疗方案是使用利妥昔单抗、环磷酰胺、多柔比星、长春新碱和泼尼松进行化疗免疫治疗（R-CHOP）。众多试验都未能成功在这些患者中取得更好的疗效。最近，III期POLARIX试验的结果发表了。该研究将新诊断的DLBCL患者随机分为两组，一组接受泊洛妥珠单抗维泊妥英联合利妥昔单抗、环磷酰胺、多柔比星和泼尼松（pola-R-CHP）治疗，另一组接受标准治疗方案R-CHOP。POLARIX试验表明，pola-R-CHP组的2年无进展生存率为76.7%，而R-CHOP组为70.2%，两组的安全性相当。基于这些结果，DLBCL患者可能正在出现一种新的治疗标准。本文提供了一种管理新诊断DLBCL患者的实用方法。
