TY - JOUR
T1 - Relapsed or Refractory Diffuse Large B-Cell Lymphoma
T2 - “Dazed and Confused”
AU - Kesireddy, Meghana
AU - Lunning, Matthew A.
N1 - Funding Information:
AstraZeneca, Bayer, Genentech, and Natera Inc; and has equity in Compass Therapeutics and Processa; SS has consulted for AstraZeneca, Genentech, Ipsen, Imvax Inc, and QED Therapeutics; NVU has consulted for AstraZeneca, BostonGene, Incyte, Helsinn Healthcare SA, QED Therapeutics, and Taiho Oncology, Inc.; has received research funding from EMD Serono, Ipsen, and Taiho Oncology, Inc.; and has long position holdings in Exact Sciences and Natera Inc.
Funding Information:
a consultant for Bristol Myers Squibb/ Celgene, GSK plc, Janssen Pharmaceuticals, Oncopeptides, Pfizer, Sanofi, Secura Bio, and Takeda Pharmaceutical Company; and has received research funding from Oncopeptides.
Funding Information:
The study was conceived in 2013 and a letter of intent for the protocol was approved by Genentech on September 4, 2014. The study was approved by the Yale University institutional review board on November 13, 2014, and activated for accrual on April 27, 2015. Genentech provided omalizumab as an investigational agent and partial financial support for the trial.
Funding Information:
funds from the Susan G. Komen Foundation. Telli is an associate professor of medicine (oncology) in the Division of Medical Oncology at Stanford University School of Medicine, director of the Stanford Cancer Institute’s Breast Cancer Program, and associate director of the Stanford Women’s Cancer Center. This year, the Susan G. Komen Foundation awarded $21.7 million to 48 new research projects across 26 different academic medical institutions.
Publisher Copyright:
© 2022 UBM Medica Healthcare Publications. All rights reserved.
PY - 2022/6
Y1 - 2022/6
N2 - Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma. Approximately 30% to 40% of patients will develop relapsed/refractory (R/R) DLBCL, leading to significant morbidity and mortality. Salvage chemoimmunotherapy followed by high-dose chemotherapy and autologous stem cell rescue (HDT-ASCR) is the standard of care for chemosensitive and transplant-eligible R/R DLBCL. In patients who are ineligible for HDT-ASCR or who fail HDT-ASCR, treatment is mostly with palliative intent. However, the recent advances with chimeric antigen receptor T-cell (CAR-T) therapy and several FDA-approved targeted agents are changing the current landscape of R/R DLBCL management. There is no one-size-fits-all approach, and guidance regarding optimal sequencing of subsequent therapies is an unmet need. This review highlights the approved CAR-T constructs, including their efficacy, adverse effects, and real-world data; bridging therapy to CAR-T; the role of emerging targeted agents, including bispecific antibodies; and the timing of these targeted agents in relation to CAR-T therapy. Providing individualized treatment with thoughtful sequencing of available agents is essential until future prospective randomized clinical trials provide more insights.
AB - Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma. Approximately 30% to 40% of patients will develop relapsed/refractory (R/R) DLBCL, leading to significant morbidity and mortality. Salvage chemoimmunotherapy followed by high-dose chemotherapy and autologous stem cell rescue (HDT-ASCR) is the standard of care for chemosensitive and transplant-eligible R/R DLBCL. In patients who are ineligible for HDT-ASCR or who fail HDT-ASCR, treatment is mostly with palliative intent. However, the recent advances with chimeric antigen receptor T-cell (CAR-T) therapy and several FDA-approved targeted agents are changing the current landscape of R/R DLBCL management. There is no one-size-fits-all approach, and guidance regarding optimal sequencing of subsequent therapies is an unmet need. This review highlights the approved CAR-T constructs, including their efficacy, adverse effects, and real-world data; bridging therapy to CAR-T; the role of emerging targeted agents, including bispecific antibodies; and the timing of these targeted agents in relation to CAR-T therapy. Providing individualized treatment with thoughtful sequencing of available agents is essential until future prospective randomized clinical trials provide more insights.
UR - http://www.scopus.com/inward/record.url?scp=85132456164&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85132456164&partnerID=8YFLogxK
U2 - 10.46883/2022.25920963
DO - 10.46883/2022.25920963
M3 - Review article
C2 - 35723942
AN - SCOPUS:85132456164
SN - 0890-9091
VL - 36
SP - 360
EP - 369
JO - Oncology (United States)
JF - Oncology (United States)
IS - 6
ER -