The Fellow on Call: The Heme/Onc Podcast Episode 078: Management of relapsed diffuse large B-cell lymphoma (DLBCL) - Part 2
Oct 25, 2023
This podcast dives deep into the management of relapsed diffuse large B-cell lymphoma, exploring innovative treatments like selective antibodies against CD19. The discussions highlight exciting alternative therapies, including loncastuximab and combination regimens with tafacitimab and lenalidomide. Listeners hear about the promising results from clinical trials and the evolving strategies post-CAR-T therapy. It also evaluates the potential of allogeneic transplants in DLBCL management, painting a hopeful future for lymphoma treatments.
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Platinum Sensitivity Guides Treatment
- Assess platinum sensitivity for relapsed DLBCL patients to guide treatment choices.
- Use platinum-based regimens like RICE or RGDP, adding CNS-directed therapies if CNS relapse occurs.
New CD19-Targeted Therapies
- Loncastuximab targets CD19 and works well in heavily pretreated, high-risk DLBCL patients.
- Tafacitimab plus lenalidomide shows durable responses especially in less aggressive relapses and is given for a fixed duration.
BiTE Therapy After CAR-T Relapse
- After CAR-T relapse, use bispecific T-cell engager (BiTE) therapies such as epcoritamab or glofitimab.
- BiTE therapies don't require leukapheresis and may provide durable responses with manageable toxicities.