Aggressive lymphomas progress rapidly and are prone to relapse, with existing treatments still failing to achieve a satisfactory cure rate. Particularly for high-risk patient groups, the demand for precise and efficient treatments is more urgent. The 12th Annual Meeting of the Society for Hematologic Oncology (SOHO 2024) was held in Houston, USA, from September 4th to 7th, 2024, attracting top experts in the field of hematologic malignancies from around the world to exchange the latest research findings and discuss new strategies for treatment. During the conference, "Hematology Frontier" had the honor to interview Dr. Astrid Pavlovsk from the Pavlovsky Center. She provided an in-depth analysis of the efficacy, safety, and current status of new therapies in the treatment of aggressive lymphomas, with a special focus on key issues such as patient individual differences, offering insights for clinical practice.

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Hematology Frontier：What data currently supports the long-term efficacy and safety of novel therapies in the treatment of aggressive lymphoma?

Dr. Astrid Pavlovsk：We have different follow-up on the newest treatment strategies. The longest follow-up of CAR-T cell in lymphoma showing there is a curability of about 20% of the patients with an overall survival at 3 years of about 40% of the patients. This is the longest survival. I think we do have patients that get cured from that therapy. Regarding my specifics in diffuse B cell lymphoma. There is a plateau showing that we need further follow-up to see if these patients are actually cured from the disease.

Hematology Frontier：What is the current status of novel therapies for aggressive lymphoma in clinical practice? And what are the limiting factors?

Dr. Astrid Pavlovsk：The limiting factors are very variable, depending on where the patient lives, the economical resources, the countries where they have the center, where they are being treated. Some patients can easily have access to CAR-T, to clinical trials, to bispecifics and to novel agencies. Many patients around the world are still treated with chemotherapy and autologous stem cell transplantation and maybe other genetics transplantation. As the Spanish data showed, this has an impact on overall survival. So access is very diverse around the world.

Hematology Frontier：How are individual difference among patients considered and addressed in novel therapies?

Dr. Astrid Pavlovsk：I think the biggest difference comes into the time of relapse. For those patients that have early relapse or primary refractory disease, these treatments are less effective. For patients who have more lines of therapy, it’s not the same to have novel therapy after 2 lines of therapy as it is to have it after 5 lines of therapy. So I think time to relapse and the number of lines of treatment you have received are the most important factors.

Hematology Frontier：What do you think the clinicians can do to improve the accessibility of novel therapies?

Dr. Astrid Pavlovsk：Clinical trials. I think in countries with low and middle income patients have no access to this very expensive therapy. So at least we can include patients into clinical trials. And our patients could have an opportunity. And hopefully the price for these drugs should not be the same all around the world. There are countries that can definitely not afford these prices.