Lu Tingxun, Zhang Jie, Xu-Monette Zijun Y, Young Ken H
Department of Oncology, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu Province, 214122, China.
Division of Hematopathology, Department of Pathology, Duke University School of Medicine, Durham, NC, 27710, USA.
Exp Hematol Oncol. 2023 Aug 14;12(1):72. doi: 10.1186/s40164-023-00432-z.
Diffuse large B-cell lymphoma (DLBCL) can be cured with standard front-line immunochemotherapy, whereas nearly 30-40% of patients experience refractory or relapse. For several decades, the standard treatment strategy for fit relapsed/refractory (R/R) DLBCL patients has been high-dose chemotherapy followed by autologous hematopoietic stem cell transplant (auto-SCT). However, the patients who failed in salvage treatment or those ineligible for subsequent auto-SCT have dismal outcomes. Several immune-based therapies have been developed, including monoclonal antibodies, antibody-drug conjugates, bispecific T-cell engaging antibodies, chimeric antigen receptor T-cells, immune checkpoint inhibitors, and novel small molecules. Meanwhile, allogeneic SCT and radiotherapy are still necessary for disease control for fit patients with certain conditions. In this review, to expand clinical treatment options, we summarize the recent progress of immune-related therapies and prospect the future indirections in patients with R/R DLBCL.
弥漫性大B细胞淋巴瘤(DLBCL)可通过标准的一线免疫化疗治愈,然而,近30%-40%的患者会出现难治或复发。几十年来,适合复发/难治性(R/R)DLBCL患者的标准治疗策略一直是大剂量化疗后进行自体造血干细胞移植(auto-SCT)。然而,挽救治疗失败的患者或不符合后续auto-SCT条件的患者预后不佳。已经开发了几种基于免疫的疗法,包括单克隆抗体、抗体药物偶联物、双特异性T细胞衔接抗体、嵌合抗原受体T细胞、免疫检查点抑制剂和新型小分子。同时,对于某些适合的患者,异基因SCT和放疗对于疾病控制仍然是必要的。在本综述中,为了扩大临床治疗选择,我们总结了免疫相关疗法的最新进展,并展望了R/R DLBCL患者未来的治疗方向。