DLBCL Treatment and Research Updates Patients Should Know About

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DLBCL Treatment and Research Updates Patients Should Know About from Patient Empowerment Network on Vimeo.

What diffuse large B-cell lymphoma (DLBCL) treatment and research updates should patients know about? Expert Dr. Amitkumar provides an overview of recent updates and shares credible resources to learn about emerging research.

Dr. Amitkumar Mehta is Director of the Lymphoma Program and CAR T Program and Medical Director of the Clinical Trials Office at O’Neal Comprehensive Cancer Center at UAB. Learn more about Dr. Mehta.

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Transcript:

Katherine:

The annual American Society of Hematology, or ASH, meeting happened recently, where DLBCL experts shared their research. Are there updates that patients should know about?

Dr. Mehta:

Absolutely. There are so many promising agents that were presented in a wide variety of different clinical trials, early phase or Phase I, Phase II, and also some of the advanced studies that were discussed. The promising right now, I say in a relapse setting, potentially curative is the CAR T. There was some long-term data, a newer platform of CAR T therapy, autologous, that means where patient’s own T cells have modified. There are quite many products already approved. Their long-term data, safety, and efficacy was discussed – very impressive. The new set of cellular therapy, which includes not only CAR T but other immune cell like NK cell therapy, which are also presented – very impressive. Now, remember, we need to auto our own CAR-T cells being processed. There is a time lag, about two or three weeks for preparing those cells compared to the others they’re over the shelf.

Of course, all of this data are early, but they are very promising going forward. The others are bispecific antibodies. So, so far what we have is the monoclonal antibodies targeting single antigen like CD20 or CD19. But now we have bispecific, which targets CD20 on one end but CD3, the T-cell antigen on the other end. And those antibodies have proven very effective in all B-cell lymphoma and large-cell lymphoma.

And there are so many other agents in early phase. As we go out more in-depth going forward, we will lower their efficacy and side effects and how they fare compared to the other approved agents. So, very exciting time for lymphoma patients. So, that even if it comes back, we have multiple options to have it back in remission and potentially a cure going forward.

Katherine:

Yeah. No, that’s great. How can patients learn more about emerging research?

Dr. Mehta:

Very important question. And currently, as we were discussing, Googling sometimes is not the right way because it is unfiltered information. And its sample size could be different. Somebody has a negative experience, and they would write that, and the person reading might have a different perception of the diagnosis and treatment. There are good websites, American Society of Hematology, American Society of Clinical Oncology, Lymphoma & Leukemia Society.

There are many other cancer societies. They have good information available. But the most important is actually the responsibility, in my opinion, lies on the provider. When the patient comes and sees me, I make sure that I share the information with the patient. And I direct them to the right source of information, and it should be interactive.

That means if they read something if they have any questions, they come back and ask me. At the end, it is our responsibility as a care team to be available, first of all, for any questions and provide right information. What I’ve learned through a period of time that that has helped patient quite a bit all across so that they don’t have to wander around for nonspecific information like on Google or other search platforms

DLBCL Treatment Approaches for Newly Diagnosed and Relapsed/Refractory Patients

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DLBCL Treatment Approaches for Newly Diagnosed and Relapsed/Refractory Patients from Patient Empowerment Network on Vimeo.

What are current diffuse large B-cell lymphoma (DLBCL) treatment approaches for newly diagnosed and relapsed/refractory patients? Expert Dr. Amitkumar Mehta outlines treatment options, explains how treatments have evolved, and discusses patient monitoring following treatment completion.

Dr. Amitkumar Mehta is Director of the Lymphoma Program and CAR T Program and Medical Director of the Clinical Trials Office at O’Neal Comprehensive Cancer Center at UAB. Learn more about Dr. Mehta.

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Tools for Setting DLBCL Treatment Goals

Transcript:

Katherine:

What treatment options are available for DLBCL patients?

Dr. Mehta:

So, it’s a very loaded question because, you know, front-line and relapse and field has evolved immensely over a period of years. But I’ll tell you that in a new diagnosis of DLBCL, still R-CHOP or R-EPOCH-based treatments are standard of care. We have – as a medical community, we have tried multiple times to improve upon the foundation of R-CHOP or R-EPOCH. But we have failed, unfortunately, that R-CHOP is still the best treatment.

There are multiple clinical trials, which are building on R-CHOP adding novel agents and see whether it gets better or not. So, therefore, when we discuss, we discuss always to ask about whether there is any clinical trial option. If the DLBCL comes back, which happens in about 30 to 40 percent of cases, there are so many treatment options.

There are novel options including bone marrow transplant. The CAR-T treatment, tafasitamab (Monjuvi), different CD19-directed therapies, or loncastuximab (Zynlonta) CD19-directed antibody drug conjugate. There are so many – polatuzumab (Polivy) – options available. Therefore, it is important to have a discussion with your provider that “Okay. Well, if it has come back, of course, it is disappointing. But what are my options, clinical trial options, novel therapeutic options,” so that we can work as a team with betterment and hoping to cure even if it has come back, a large cell lymphoma.

So, there are so many treatment options out there. I did not touch upon the clinical trial. There are so many clinical trials going on within amazing agents, which are very effective in DLBCL.

Katherine:

How are DLBCL patients monitored after treatment is completed?

Dr. Mehta:

Very importantly, if you go in remission and after the initial treatment or in a relapse setting, we have to keep an eye. And, of course, we want to detect if it comes earlier so that we can start the treatment earlier. Typically, in the beginning, in the initial two years, the follow-up could be closer, every four to six months we get together.

We have labs done. Sometimes we do scans, making sure that a lymphoma – there is no evidence of it coming back. So, the initial two to three years the follow could be closer. And then, as we space out, the follow spaces out further. And then, after you have a five-year mark where the lymphoma has not come back, the chance of it coming back goes further down. So, then I start follow-up annually on those patients. Yeah.

Tools for Setting DLBCL Treatment Goals

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Tools for Setting DLBCL Treatment Goals from Patient Empowerment Network on Vimeo.

Expert Dr. Amitkumar Mehta shares key steps for collaborating on diffuse large B-cell lymphoma (DLBCL) treatment goals with your healthcare team.

Dr. Amitkumar Mehta is Director of the Lymphoma Program and CAR T Program and Medical Director of the Clinical Trials Office at O’Neal Comprehensive Cancer Center at UAB. Learn more about Dr. Mehta.

See More from Thrive DLBCL

Related Resources:

DLBCL Treatment Approaches for Newly Diagnosed and Relapsed_Refractory Patients

DLBCL Treatment Approaches for Newly Diagnosed and Relapsed/Refractory Patients

 How Can DLBCL Patients Benefit From Shared Decision-Making

How Can DLBCL Patients Benefit From Shared Decision-Making?

 Why Should DLBCL Patients Feel Empowered to Speak Up

Why Should DLBCL Patients Feel Empowered to Speak Up?

Transcript:

Katherine:

When someone is considering DLBCL treatment, what advice do you have for setting treatment goals with their healthcare team?

Dr. Mehta:

So, for any cancer and particularly DLBCL, the understanding of DLBCL is very, very important. So, what we do in our clinic, and I think it should it be a very standard process all across, is when I sit down with a patient with a new diagnosis of DLBCL, obviously, they’re in shock, number one. Number two, remember, if you go back 10 to 15 years, we did not have this much information. Now, you can Google it and find so much information.

It may be a positive, may be a negative. And, within a day, you are expert in DLBCL, right? But that’s not how it should be. So, the most important part, in the first visit, I sit down with my patient for an hour, hour-and-a-half. It’s an overwhelming visit for them, because I share a lot of information with them. So, the first thing is information. Second thing is trust with your team. It’s not just me. It’s my nurse. It’s my nurse practitioner. What is infusion center? What is a PET scanner? What I’m going to get as chemotherapy? What is the treatment looks like? So, all of this is a very important information.

And I always leave a door open that first visit. Don’t get overwhelmed. You may come back if you have more questions. Write down those questions, and we will discuss that again. And then it’s more afterwards. They can call to the clinic. They can send a message, and we’ll respond. So, I think when we have all this information, they know the whole layout, right?

It is just like – say, we are planning a vacation. We are going for – somewhere out of country, right? So, what we need to know. Where we are going information, flight details, hotel details, currency, everything. If you have that, then you are at ease. That I know the whole treatment plan. I know what’s going to happen when, expected timelines. I also know what are the potential side effects to the treatment. And, of course, what is the intent of the therapy, right? It may be a cure.

In DLBCL setting, 60 percent of patients will be cured. All of that information is a treatment plan, and that has to be very transparent and open with the patient so that they feel comfortable that what I’m going through, when things will happen, who are people in the care team that I can approach if I have any questions?