Diffuse large B-cell lymphoma, a new strategy reduces the risk of having a relapse

Diffuse large B-cell lymphoma, a new strategy reduces the risk of having a relapse


Of Vera Martinella

A combination approved in Italy for adult patients with this aggressive, untreated blood cancer. A step forward after 20 years: the chances of healing with the first cycle of treatment are growing

For the first time in 20 years, a new treatment is available for use on the front line in adult patients diagnosed with diffuse large B-cell lymphoma, the most common form of non-Hodgkin lymphoma. The Italian Medicines Agency has, in fact, granted reimbursement to an innovative drug (polatuzumab) in combination with chemotherapy in previously untreated patients after the results of the trials indicated that this strategy reduces the risk of tumor progression, relapse or death by 27%. compared to the current standard chemotherapy regimen.

For patients most at risk of relapses

The diffuse large B-cell lymphoma represents approximately 30% of all aggressive lymphomas, which have a more rapid clinical course and require timely treatment. It is a blood cancer characterized by rapid growth of B lymphocytes, a type of white blood cell (immune system cell), which is diagnosed around 13,200 Italians every year.
Although a considerable percentage of patients respond positively to initial treatment, nearly four in 10 show no response or experience a relapse. And Aifa’s green light specifically concerns those with a neoplasm intermediate or high risk of recurrence (with the so-called prognostic index factor (PII) 3-5.

The advantages of the new treatment

«Polatuzumab in combination with the R-CHP chemotherapy regimen (i.e. rituximab, cyclophosphamide, doxorubicin and prednisone) is the first therapy after approximately 20 years to have demonstrated a significant benefit in terms of disease progression-free survival for the first-line treatment of diffuse large B-cell lymphoma – he explains Maurizio Martelli, Full Professor and Director of Hematology at the University Hospital Policlinico Umberto I Sapienza University of Rome -. A step forward to the current standard therapy (R-CHOP, i.e. rituximab plus cyclophosphamide, doxorubicin, vincristine and prednisone) which could significantly improve outcomes and bring tangible benefits to those facing this aggressive lymphoma.” TO demonstrate the benefits of the new combination were the results of the phase three POLARIX study, which enrolled 879 patients and indicated that people treated with polatuzumab plus R-CHP, at a two-year follow-up, receive much fewer subsequent therapies (systemic, radiotherapy , autotransplantation and CAR-T) compared to those treated with R-CHOP.

Chance to heal

«This new therapy, arrived after decades of attempts, increases the chances of recovery of patients with the first line of treatmenttherefore reducing the need to resort to second and third line therapies, which are often very burdensome and demanding for patients and for the sustainability of the healthcare system – he clarifies Antonello Pinto, medical director of the National Cancer Institute Pascale Foundation IRCCS of Naples –. It is therefore a therapeutic strategy that not only reduces the risk of relapse, but also contributes to preserving and improving the quality of life of patients.” To treat this neoplasm, even in cases where relapses occur, innovative therapies such as CAR-Twhich are the patient’s T lymphocytes enhanced to attack tumor cells (already approved in our country)or the bispecific antibodieswhich bind T lymphocytes to the tumor cell, allowing their destruction.

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March 28, 2024 (modified March 28, 2024 | 07:34)


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