[Recent advances in the treatment of DLBCL].

Kana Miyazaki
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Abstract

Diffuse large B-cell lymphoma (DLBCL) accounts for approximately 40% of all malignant lymphomas, making it the most common subtype. Molecular genetic studies have elucidated the pathogenesis of DLBCL and the causes of its poor prognosis. This basic research has led to the development of novel molecularly targeted therapies that target molecules and cellular antigens in relevant signaling pathways or epigenetic enzymes. Treatment with polatuzumab vedotin, rituximab, cyclophosphamide, doxorubicin, and prednisone has become the standard of care for newly diagnosed CD20-positive DLBCL with an International Prognostic Index score of 2 to 5, based on its reported efficacy for this indication. In addition, the development of immunotherapy such as anti-CD19-chimeric antigen receptor (CAR)-T therapy and bispecific antibodies such as epcoritamab, mosunetuzumab, and glofitamab has led to a paradigm shift in treatment of relapsed/refractory DLBCL. This review summarizes the evolution of treatment development for DLBCL, as well as the results of the current clinical standard of care and new therapies that are expected to become the standard of care.

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[治疗 DLBCL 的最新进展]。
弥漫大 B 细胞淋巴瘤(DLBCL)约占所有恶性淋巴瘤的 40%,是最常见的亚型。分子遗传学研究阐明了 DLBCL 的发病机制及其预后不良的原因。这项基础研究促进了新型分子靶向疗法的发展,这些疗法以相关信号通路或表观遗传酶中的分子和细胞抗原为靶点。根据该适应症的疗效报告,使用泊拉珠单抗、利妥昔单抗、环磷酰胺、多柔比星和泼尼松治疗已成为新诊断的CD20阳性、国际预后指数评分为2至5分的DLBCL的标准治疗方法。此外,抗CD19-嵌合抗原受体(CAR)-T疗法和双特异性抗体(如epcoritamab、mosunetuzumab和glofitamab)等免疫疗法的发展导致了复发/难治性DLBCL治疗模式的转变。本综述总结了DLBCL治疗发展的演变,以及目前临床标准疗法和有望成为标准疗法的新疗法的结果。
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