UCSD Lymphoma Trial: Loncastuximab Tesirine and Rituximab Followed by DA-EPOCH-R for Treating Patients With High-Risk Diffuse Large B-cell Lymphoma

Rákkutatás · Diffuse large B-cell lymphoma

Ibrutinib–rituximab regimen resulted in progression‑free survival and overall survival that were superior to those with a standard chemoimmunotherapy regimen among patients 70 years of age or younger with previously untreated CLL.

A phase‑II, single‑arm, interventional study conducted at UC San Diego and UC Davis evaluates the safety, tolerability, and preliminary anti‑tumor activity of a sequential therapy comprising loncastuximab tesirine plus rituximab (Lonca‑R) followed by dose‑adjusted doxorubicin, etoposide, vincristine, cyclophosphamide, and prednisone (DA‑EPOCH‑R). Eligible patients are adults (≥18 years) with untreated high‑risk diffuse large B‑cell lymphoma (DLBCL) defined by double‑expressor or double‑hit biology (MYC > 40 % and BCL2 > 50 % by IHC, or MYC/BCL2/BCL6 rearrangements). The primary endpoint is overall response rate (complete + partial responses) assessed by PET‑CT. Secondary endpoints include event‑free survival, overall survival, safety (CTCAE v5.0), and biomarker correlatives (MYC, BCL2, BCL6, CD19, CD20). The study intends to enroll 24 patients over 2 years, with a preliminary safety and efficacy readout after 12 months of follow‑up.

In patients 70 years or younger with untreated chronic lymphocytic leukemia, the combination of ibrutinib and rituximab provides markedly superior progression‑free survival (89.4 % vs. 72.9 % at 3 years) and overall survival (98.8 % vs. 91.5 % at 3 years) compared with the standard fludarabine‑cyclophosphamide‑rituximab regimen, establishing a new first‑line therapeutic option.

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