An international team of doctors led by Joshua Brody, MD, Director of the Lymphoma Immunotherapy Program at The Tisch Cancer Institute at Mount Sinai, has made a major breakthrough in treating a common and challenging form of cancer called diffuse large B-cell lymphoma (DLBCL).
In a clinical trial known as EPCORE NHL-2, the researchers showed the benefit of combining chemotherapy with immunotherapy for DLBCL. The results, published earlier this month in the journal Blood, offer new hope for patients whose lymphoma has returned or has not responded to standard treatments.
Lymphoma is the fifth most common cancer in the United States and DLBCL is the most prevalent subtype. For patients who relapse or do not respond well to first-line therapy, two of the most common treatment approaches are immunotherapy (with CD3xCD20 bispecific antibodies) or chemotherapy (gemcitabine plus oxaliplatin). This is the first published clinical trial combining those two approaches; it yielded complete remission rates markedly higher than either approach alone, and showed comparable safety.
DLBCL is the most common type of non-Hodgkin lymphoma (NHL) in the United States, accounting for about one out of every three lymphomas . DLBCL can affect people of any age, but it occurs mostly in older people. The average age at the time of diagnosis is mid-60s. It usually starts as a quickly growing mass in a lymph node deep inside the body, such as in the chest or abdomen, or in a lymph node you can feel, such as in the neck or armpit. It can also start in other areas, such as the intestines, bones, or even the brain or spinal cord.
"For patients whose first treatments don't work, options have been limited, but this study tried something new: combining immunotherapy with chemotherapy," said Dr. Brody. "Immunotherapy uses the body's own immune system to fight cancer, while chemotherapy uses drugs to kill cancer cells. The study combined these treatments and got amazing results, with many more patients seeing their cancer disappear than with either treatment alone."
According to Dr. Brody, this new combination treatment could completely change how we treat patients with relapsed or hard-to-treat DLBCL. In this research trial, more patients went into complete remission with this combination than with either treatment alone. Another study coming soon, called STARGLO, will test a similar approach and could confirm these findings.
"Our next goal is to see if we can use this combination as part of the first treatments for DLBCL to help even more patients," said Dr. Brody.
This study involved doctors and researchers from the University of Michigan and Karolinska Institutet in Sweden.
