Wojciech Jurczak, MD, PhD, head of the Department of Oncology at Maria Sklodowska-Curie National Research Institute of Oncology, discusses the changing therapy landscape for relapsed or refractory diffuse large B-cell lymphoma (DLBCL).
Wojciech Jurczak, MD, PhD, head of the Department of Oncology at Maria Sklodowska-Curie National Research Institute of Oncology, discussed the changing therapy landscape for relapsed or refractory diffuse large B-cell lymphoma (DLBCL).
How might the findings of the phase 2 L-MIND study help inform clinical practice and treatment decisions for patients with relapsed or refractory DLBCL?
The perspective of relapsing/refractory diffuse large B-cell lymphoma is changing evidently. We have the dusk of classical chemotherapy as we know, including high-dose chemo, and transplant is gradually replaced by a targeted chemotherapy, molecular targeted agents, and, last but not least, immunotherapy. It is difficult to use molecular targeted agents with the present diagnostic methods—it should be noticed that even at this EHA [European Hematology Association annual meeting], there were some data on CDK9 inhibitors. The targeted chemotherapy is widely used, but what's most important is immunotherapy.
Now, the CAR [chimeric antigen receptor] T cells are approved in the third line and now are being moved to the second line of therapy. The targeted chemotherapy approved in the second line after the POLARIX study is gradually moved to the first line, with immunities like [the] TAFA-LEN [tafasitamab plus lenalidomide] regimen being reserved for the patients who are not eligible for the CAR T-cell therapies either because of age, comorbidities, or logistical problems. As this is a regimen which is excellently tolerated, we can still offer it to the majority of elderly populations, which we do not like to treat with a more harsh Pola-BR regimen, including targeted chemotherapy [polatuzumab vedotin and rituximab] together with bendamustine.