Exploring Current and Future Treatment in Patients With DLBCL

Mitul Gandhi, MD

Mitul Gandhi, MD, a medical oncologist at Virginia Cancer Specialists, discusses the current landscape for patients with diffuse large B-cell lymphoma (DLBCL) and what may be coming in the future.

Gandhi feels that 5 and 10 years into the future of the DLBCL setting has become a long time to look ahead because of the pace of change is accelerating. There have been 2 FDA approvals for targeted agents in the past few years for DLBCL, one of which was the CD79b­–directed antibody drug conjugate polatuzumab vedotin-piiq (Polivy) in 2019. The other, a naked CD-19 antibody drug conjugate called tafasitamab-cxix (Monjuvi), was approved in 2020. The treatments and strategies in DLBCL are expected to rapidly expand in the year.

As trials evolve and physicians get more experience with the available drugs, Gandhi expects that there will be increased use of combination targeted therapy options with a tapered cytotoxic backbone. These combinations may eventually replace the R-CHOP regimen (rituximab [Rituxan], cyclophosphamide, doxorubicin, vincristine, prednisone) as the options with the most efficacy in patients with DLBCL. The upcoming era will probably be comprised of combined targeted therapy and cellular therapy early in the disease site with either chimeric antigen receptor T-cell therapy or off-the-shelf bispecific antibodies, according to Gandhi.