Tag Archive for: polatuzumab

What Promising Treatments Are Available for Diffuse Large B-Cell Lymphoma Patients?

What Promising Treatments Are Available for Diffuse Large B-Cell Lymphoma Patients? from Patient Empowerment Network on Vimeo.

What promising diffuse large B-cell lymphoma (DLBCL) treatments are available for patients? Expert Dr. Nirav Shah from Medical College of Wisconsin shares an update on emerging research and patient types who may benefit from potential treatment approvals.

Dr. Nirav Shah is an Associate Professor at the Medical College of Wisconsin. Learn more about Dr. Shah.

[ACT]IVATION TIP:

“…understand their stage of disease and review the treatment options available for that stage and subtype of diffuse large B-cell lymphoma to best optimize the regimen to each individual patient.”

See More from [ACT]IVATED DLBCL

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How Do Different Diffuse Large B-Cell Lymphoma Subtypes Impact Treatment Options

How Do Different Diffuse Large B-Cell Lymphoma Subtypes Impact Treatment Options

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What DLBCL Treatment Options Are There for Relapsed/Refractory Patients

Is Stem Cell Transplantation Still a Treatment Option for Some DLBCL Patients

Is Stem Cell Transplantation Still a Treatment Option for Some DLBCL Patients


Transcript:

Lisa Hatfield:

Dr. Shah, can you speak to some promising treatments that are available now for DLBCL patients? 

Dr. Nirav N. Shah:

Yeah, so while we consider DLBCL to be one disease, there is a lot of heterogeneity in it, and so there are sort of subtypes of DLBCL that we approach differently. And so the most well-known standard of care for DLBCL is a chemotherapy regimen called R-CHOP. It’s a five-drug regimen, it’s given once every three weeks for up to six cycles, again, depending on the stage, the presentation that the patient is in.

However, the goal has always been to do better than R-CHOP and there is an exciting new regimen called pola-R-CHP which gives you a drug called polatuzumab (Polivy) in lieu of an older drug called vincristine (Vincasar PFS), which is part of the R-CHOP regimen, and that regimen was tested head-to-head against R-CHOP chemotherapy and did have a slight improvement about a benefit of 5 percent to 6 percent in terms of its ability to induce a long-term remission, and again, that number may sound small, but every patient matters, and so that regimen, some of us have started adapting that, although I will note that that regimen is currently not FDA-approved, and so its accessibility and availability may be limited, although I’m optimistic that this regimen will be approved and become an option for the frontline for patients to come.

There are some types of diffuse large B-cell lymphoma that are a little bit more aggressive, we call some of these double-hit lymphomas, so a term that you may hear if you’re diagnosed and it’s something a doctor may talk about, and so for those patients, we often use a higher intensive regimen, the regimen that we use at our institution is a regimen called dose-adjusted EPOCH and so you can see here that it’s a little bit complicated, there are caveats here, there’s different treatment options available, and the number of treatments we give is partially based on how you present and the stage that you initially show up with. And so I think that it’s important to have a conversation with your physician. And so my activation tip for patients is to understand their stage of disease and review the treatment options available for that stage and subtype of diffuse large B-cell lymphoma to best optimize the regimen to each individual patient. 


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DLBCL Treatment Approaches for Newly Diagnosed and Relapsed/Refractory Patients

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.

See More from Thrive DLBCL

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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.