Treatment Options for Relapsed/Refractory Diffuse Large B-Cell Lymphoma - Episode 11

Emerging Treatments for Relapsed/Refractory DLBCL

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Brian Hill, MD, PhD: There is a potential for tafasitamab in combination with lenalidomide to significantly impact the treatment landscape for diffuse large B-cell lymphoma [DLBCL] in the relapsed/refractory setting.

As I mentioned, the standard approach really should still be CAR [chimeric antigen receptor] T-cell therapy for patients who are young and fit enough to receive this therapy. But for patients who relapse after CAR T cell, or who are unable to make it to an authorized treatment center for CAR T, or are of significantly advanced age or with poor performance status, in those cases more traditional pharmacologic therapies are likely to be needed. And they will probably cycle through on an ongoing basis as the patients will likely eventually lose their response to these agents.

In the case of tafasitamab, this is an anti-CD19 monoclonal antibody, which was studied in a phase 2 trial in combination with lenalidomide for patients with relapsed/refractory diffuse large B-cell lymphoma. And what was reported and recently published was that a high proportion of patients, somewhere in the 40% to 50% range, achieved reasonably long-term remission with an impressive overall response rate of this combination.

With the anticipated approval of tafasitamab, in combination with lenalidomide for diffuse large B-cell lymphoma, I think we’re going to have more in our armamentarium and more options for patients with this disease.

Andre Goy, MD: The Re-MIND study was presented at the ASCO [American Society of Clinical Oncology] annual meeting. It’s an interesting study looking at lenalidomide as a single agent in the relapsed large cell lymphoma and to use it as real-world evidence to compare with the L-MIND trial, which was tafasitamab plus lenalidomide, where I mentioned the results were very impressive. This was to try to compare the outcome of this population with a combination versus a single agent. I think this was an important work because the awareness of the importance of real-world data is increasing rapidly. And these real-world data can confirm the clinical benefits of a new trial but also give you, if we can see a control group, although this was not completely matched as a control group, to suggest that the combination was really beneficial, with the anti-CD19 in addition to lenalidomide.

Transcript edited for clarity.