A new clinical trial of a targeted combination treatment before chemotherapy has shown its effectiveness in patients with diffuse large B-cell lymphoma (DLBCL). These promising results give hope that they could in the future do without chemotherapy.
Able to appear at any age, but generally diagnosed around the age of sixty, diffuse large B-cell lymphoma (DLBCL) is a fairly common cancer, with approximately 10,000 new cases each year in France. Originating in the lymph nodes, it can also do so in organs, bones, testicles, thyroid gland, skin, etc.
A promising new trial
Evolving rapidly, diffuse large B-cell lymphoma is in the majority of cases treated with chemotherapy at all stages. A subtype of this cancer, however, responds less well to chemotherapy: called non-GCB large B-cell lymphoma, it represents 30% to 40% of cases and has an estimated cure rate of 50 to 60%.
However, it is possible to make chemotherapeutic treatment more effective by combining it with a targeted combination treatment, reports a new trial conducted at the Anderson Cancer Center at the University of Texas (USA).
Entitled “Smart Start”, this promising clinical trial, the results of which were presented at the American Society of Clinical Oncology (ASCO) congress, reveals that a combined targeted treatment consisting of rituximab, lenalidomide and ibrutinib (or RLI ), results in patients recently diagnosed with diffuse large B-cell lymphoma with a favorable treatment response rate of 84.6%. 38.5% of the patients were completely treated by the RLI, even before starting their chemotherapy.
90% remission after one year
“The responses we’ve seen have been remarkable. Over 80% of our patients responded to treatment and around 40% had a complete response, showing no signs of cancer, before receiving chemotherapy,” says Prof. Westin , lead author of the study. “All patients received standard chemotherapy in combination with these targeted treatments per protocol, and, so far, we have had a 100% response rate.”
To achieve this excellent result, the clinical trial enrolled 60 patients with non-GCB diffuse large B-cell lymphoma, who were treated with two sessions of RLI, followed by six sessions of RLI with chemotherapy. To date, more than 90% of these patients are still in remission, one year after the clinical trial. The researchers are all the more satisfied that most of the side effects observed are mild and for the most part attributable to chemotherapy.
“Standard treatment for large cell lymphoma has stalled for nearly 40 years, despite many advances in our understanding of the disease and a host of new drugs. It’s exciting to see an idea that has worked in the lab begin now to give results and to show that this is a new way to fight this disease”, rejoices Professor Westin.
Now he plans to launch new clinical trials with his colleagues to determine if patients who respond well to RLI treatment from the outset can receive little or no chemotherapy and achieve long-term remission.
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