Large Cell Lymphoma: Novel Therapeutic Approaches

Dear Colleagues,

Diffuse large B-cell lymphoma (DLBCL) is an aggressive and heterogeneous disease. Recently, the new WHO classification updated different DLBCL subgroups. Around 60% of patients are cured with the frontline treatment R-CHOP. In the last 20 years, many efforts have been made to improve the outcome over R-CHOP without success. Recent studies combining the anti-CD79b antibody–drug conjugate polatuzumab vedotin plus R-CHP showed promising results. Salvage high-dose chemotherapy with autologous-stem-cell transplant remains the standard second-line treatment for patients who are refractory or relapse (R/R); the anti-CD19 chimeric antigen receptor T-cells (CAR-Ts) are considered the standard of care as third-line therapy, and are moving as second-line for those patients who are primary refractory or have an early relapse. Recently, new therapies have been approved for R/R DLBCL for transplant-ineligible patients, as the combinations polatuzumab plus rituximab-bendamustine and tafasitamab plus lenalidomide. Despite all these new strategies, there is still much room to improve the outcome of DLBCL patients, and new strategies are ongoing. Monoclonal antibodies such as loncastuximab, and bispecific antibodies (BsAbs) including mosunetuzumab, glofitamab, epcoritamab and odeonextamab have shown very promising results. There are also preliminary results of new tailored therapies based on molecular subtypes of DLBCL.

On the other hand, there are still unresolved situations in DLBCL, such as the identification of patients with high risk of central nervous system (CNS) progression and the use of prophylaxis, as well as the treatment of patients with proven secondary CNS infiltration.

In this Special Issue, the new WHO classification, therapies available and upcoming for both frontline and R/R settings, and the special risk situations in DLBCL will be assessed.

Prof. Dr. Eva González-Barca
Guest Editor

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• diffuse large B-cell lymphoma
• molecular subtypes
• immunotherapy
• monoclonal antibodies
• bispecific antibodies
• CAR T-cells
• targeted therapies
• CNS infiltration