ASH 2023: What Is the Latest ‘Practice-Changing’ Research in DLBCL?

In this episode of The HemOnc Pulse, Alan Skarbnik, MD, of Novant Health, discusses practice-changing research in diffuse large B-cell lymphoma (DLBCL) presented at the 65th American Society of Hematology (ASH) Annual Meeting & Exposition.

Dr. Skarbnik and host Chadi Nabhan, MD, MBA, FACP, discuss a phase II study of 50 patients with secondary central nervous system lymphoma who received ibrutinib with temozolomide, etoposide, liposomal doxorubicin, dexamethasone, and rituximab.

Dr. Skarbnik highlights the discrepancy of one-year progression-free survival (PFS) and overall survival (OS) rates between patients who were ibrutinib-responsive versus patients who were ibrutinib-resistant. Specifically, the PFS and OS rates were 57% and 73%, respectively, for ibrutinib-responsive patients, and the PFS and complete response rates were 16% and 47%, respectively, for ibrutinib-resistant patients. 

“The interesting part for me here is that ibrutinib sensitivity was highly discerning between patients who would have a better outcome or a worse outcome,” Dr. Skarbnik said. “You can call it a predictor.” 

Dr. Skarbnik mentioned that he would adopt this treatment for his own patients with DLBCL with specific features, such as non-germinal center B-cell-like subtype. 

“I think it’s something exciting, in a way, given the unmet need for this population, and it is potentially practice-changing for that small patient population,” Dr. Skarbnik said. 

Other studies Drs. Skarbnik and Nabhan discuss include at study that looked at chimeric antigen receptor T-cell infusion in patients with LBCL in complete remission, and another that studied lenalidomide, tafasitamab, rituximab, and acalabrutinib, both alone and with combination chemotherapy for newly diagnosed DLBCL.