Diffuse large B-cell lymphoma (DLBCL) is a typical B-cell lymphoma, characterized by high invasiveness and heterogeneity. After standard first-line treatment, some patients still face relapse/refractory issues and relatively poor prognosis. Recently, the “7th Beijing Thrombosis and Hemostasis Conference and the 5th Beijing Hematology Oncology and Immunology Summit Forum” was successfully held in Beijing from March 1st to 3rd, 2024. After the conference, Oncology Frontier – Hematology Frontier specially invited Professor Jun Zhu from Peking University Cancer Hospital to share the unmet needs of DLBCL patients and their treatment strategies.
Oncology Frontier – Hematology Frontier: DLBCL is a malignant tumor of the hematopoietic system. What are the unmet needs for relapsed/refractory DLBCL patients? Professor Jun Zhu: Diffuse large B-cell lymphoma (DLBCL) is the most common type of lymphoma, accounting for about 40%-45% of all non-Hodgkin lymphomas. Over the past 20 years, DLBCL has been primarily treated with R-CHOP chemotherapy regimens, achieving clinical cure rates of 60%-70%. However, 20%-30% of patients still experience primary resistance or relapse/progression after treatment.
For these patients, if relevant indicators or high-risk factors can be identified at diagnosis, stratified treatment can be implemented promptly to improve prognosis. For patients with relapsed/progressive disease after treatment, second-line or third-line treatments should be based on previous treatment conditions, including the addition of new drugs or regimens to the previous treatment. Various new drugs can be used for high-risk patients, including antibody drugs, ADC drugs, and antibody-drug conjugates, which can regulate cell signaling pathways and the immune microenvironment to improve efficacy. In recent years, cellular therapy has developed rapidly, and treatments such as CAR-T cell therapy can provide new treatment strategies for patients.
These treatment strategies provide more opportunities for relapsed/refractory or primary resistant DLBCL patients. For DLBCL patients, accurate diagnosis, precise staging, standardized treatment, stratification whenever possible, and selection of appropriate treatment regimens are essential to maximize the chances of cure.
Oncology Frontier – Hematology Frontier: Is targeted therapy effective for patients who have not responded to the R-CHOP regimen? Professor Jun Zhu: For patients who have failed R-CHOP treatment, we still adhere to the basic direction of precise treatments such as immunotherapy and targeted therapy, combined with other strategies such as monoclonal antibody drugs, small molecule drugs, cellular therapy, and classical traditional treatments, to find individualized treatment plans for patients and pave the way to cure.
Oncology Frontier – Hematology Frontier: How should we choose treatment regimens to achieve personalized treatment and maximize patient benefits? Professor Jun Zhu: First, we should follow the basic path of standardized diagnosis and treatment and combine our own experience and actual conditions to boldly explore innovative attempts. The overall direction remains the combination and comprehensive treatment strategies. For these patients, under accurate diagnosis, accurate analysis, and innovative treatments, the treatment efficacy will definitely be improved.
Professor Jun Zhu
Peking University Cancer Hospital
Secretary of the Party Committee, Peking University Cancer Hospital; Director of the General Internal Medicine Department; Director of the Lymphoma Department
Concurrently serving as the Vice Chairman of the Board of Directors, Chinese Society of Clinical Oncology (CSCO)
Vice Chairman of the Supervisory Board, Chinese Society of Clinical Oncology
Vice Chairman, Beijing Hope-CSCO Clinical Oncology Research Foundation
Directorial Committee Chairman of the Lymphoma Expert Committee, Chinese Society of Clinical Oncology
Vice Chairman, Beijing Anti-Cancer Association
President, Beijing Cancer Rehabilitation Association
Vice Director, Oncology Branch of the Chinese Medical Association
Leader of the Hematology Tumor Group, Expert Committee on Capacity Building and Continuing Education in Oncology, National Health Commission
