Dr. Flowers on Efforts to Improve Frontline Treatment in DLBCL

Christopher Flowers, MD, department chair, Department of Lymphoma/Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, discusses efforts to improve the frontline standard of care in diffuse large B-cell lymphoma (DLBCL).

The frontline standard of care therapy has not changed significantly over the past 20 years in DLBCL, Flowers says. In the early 2000s, it was observed that the addition of rituximab to standard CHOP (R-CHOP) therapy improved survival for elderly patients with DLBCL compared with CHOP alone, Flowers explains. 

Although several research efforts have attempted to improve upon frontline R-CHOP, no survival advantages have been demonstrated, Flowers says. For example, randomized phase 3 trials evaluating intensified treatment approaches, stem cell transplantation, and the addition of novel agents, including bortezomib (Velcade), lenalidomide (Revlimid), and ibrutinib (Imbruvica), have been reported without demonstrating improvement vs R-CHOP in most patients with DLBCL, Flowers concludes.