Dr. Ramakrishnan on Updates in DLBCL

Praveen Ramakrishnan, MD, assistant professor, Department of Internal Medicine, UT Southwestern Medical Center, discusses updates in diffuse large B-cell lymphoma (DLBCL) that were presented at the 2019 ASH Annual Meeting.

The Intergroup National Clinical Trials Network S1001 study evaluated whether 4 cycles of chemotherapy could abate the need for further treatment or radiation in patients with limited-stage DLBCL. The results showed excellent outcomes with limited-duration chemotherapy, says Ramakrishnan. Taken collectively with the results of the FLYER trial, the field is beginning to question the role of radiation, especially in patients with good-risk, limited-stage DLBCL. As such, chemotherapy and limited-duration chemotherapy will likely become the standard, says Ramakrishnan.

Additionally, Stephen J. Schuster, MD, of the Perelman School of Medicine, University of Pennsylvania, presented an abstract on mosunetuzumab, which is an anti-CD20 bispecific T-cell engager (BiTE) that was evaluated in heavily refractory large cell lymphoma. The study included patients who were refractory following CAR T-cell therapy. Even so, investigators reported impressive responses in this difficult-to-treat population. As such, BiTEs could offer another avenue of treatment after CAR T-cell therapy, concludes Ramakrishnan.