Author｜Sindy He
Layout Designer｜Cecilia Qin Introduction The development of lymphoma occurs when one of the white blood cells called lymphocytes grows uncontrollably. The lymphocytes in our body help our immune system fight infections by traveling around in our lymphatic system. The lymphocytes are divided into two types: T lymphocytes (T cells) and B lymphocytes (B cells).
With all types of lymphoma, diffuse large B-cell lymphoma (DLBCL) constitutes almost one-third of all clinical cases of non-Hodgkin's lymphoma (NHL). Since its discovery, this type of lymphoma has been labeled "aggressive" or "moderately to highly malignant" lymphoma. Because DLBCL is heterogeneous, it has different subtypes with different clinical characteristics, genetic changes, and treatment responses.
Is Lymphoma common? What is the rate? Non-Hodgkin's lymphoma (NHL) is one of the most common cancers worldwide, accounting for approximately 4% of all cancers. Especially in recent years, the incidence rate of lymphoma has shown a more obvious rising trend. According to the China Anti-Cancer Association (CACA), “ the annual incidence of lymphoma in China is about 75,400, with an incidence rate of 4.75/100,000, and the number of deaths is about 40,500, with a mortality rate of 2.64/100,000.”
The Development of DLBCL Treatment /r-CHOP Regimen/ r-CHOP (rituximab + cyclophosphamide + adriamycin + vincristine/vincristine + prednisone) is the current standard of care for the treatment of DLBCL, but resistance and relapse are still a problem for up to 30%-40% of patients.
/Stem Cell Transplantation/
DLBCL patients who experience refractory or relapsed results following chemotherapy often undergo stem cell transplantation. In most cases, stem cell transplants are autologous, meaning the patient receives his or her own stem cells prior to the procedure. In other cases, patients will receive an allogeneic transplant in which they receive stem cells from another donor. Similar to r-CHOP Regimen, clinical trials show a high rate of relapsed or refractory large B-cell lymphomas even after finishing treatment.
/Glofitamab-gxbm（Columvi, Genentech, Inc.)/
On June 15, 2023, the Food and Drug Administration granted accelerated approval to Glofitamab-gxbm (Columvi, Genentech, Inc.) for relapsed or refractory diffuse large B-cell lymphoma, not otherwise specified (DLBCL, NOS) or large B-cell lymphoma (LBCL) arising from follicular lymphoma, after two or more lines of systemic therapy.
The study showed that patients treated with Columvi had an overall remission rate (the sum of complete and partial remissions) of 56%, with a complete remission rate of 43% and a median duration of remission of 1.5 years. On March 25 of this year, the drug was authorized by Health Canada for conditional use in adult patients with R/R DLBCL (relapsed or refractory diffuse large B-cell lymphoma), follicular lymphoma-transformed diffuse large B-cell lymphoma (DLBCL), or primary mediastinal B-cell lymphoma (PMBCL), who are subject to second-line or higher systemic systemic therapy and who are not candidates for receive or cannot receive CAR-T cell therapy or have received prior CAR-T cell therapy.
In February of this year, the National Medicines Control Administration (NMPA) approved the drug's marketing application for Mainland of China. The drug is intended for adult patients who have received at least two lines of systemic therapy for diffuse large B-cell lymphoma (RDLBCL) or primary mediastinal large B-cell lymphoma (PMBCL) with relapsed or refractory lymphoma.
Glofitamab in Refractory Diffuse Large B-Cell Lymphoma
Glofitamab is a bispecific antibody capable of targeting both CD3 and CD20 in a 2:1 fashion. It contains a protein domain that targets CD3 protein on the surface of T cells (1 Fab arm for binding CD3 on T cells) and two protein domains that bind to CD20 protein on the surface of B cells (2 Fab arms for binding CD20 on B cells). As a result of this dual-targeting strategy, T cells are able to target and kill tumor cells with greater specificity.
Medical researchers are testing many treatments that may do more to help people with DLBCL. If you have this condition and want information about newer treatments, ask your healthcare provider about participating in a clinical trial.
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