Front line:
The frontline treatment for diffuse large B-cell lymphoma (DLBCL) is rituximab combined with cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). This regimen is the standard of care and has been shown to cure more than 60% of patients with DLBCL. The National Comprehensive Cancer Network (NCCN) guidelines also endorse R-CHOP as the first-line treatment for DLBCL.
For elderly patients, the treatment approach may be adjusted based on their fitness and comorbidities. A comprehensive geriatric assessment can help tailor the treatment, and dose-reduced regimens such as rituximab-miniCHOP may be used for very old or frail patients.
Recent advancements include the POLARIX trial, which suggests that adding polatuzumab vedotin to R-CHP (pola-R-CHP) may improve progression-free survival and could potentially replace R-CHOP in eligible patients. In non GCB subtype, with IPI 3 or higher, this may provide a better PFS.
Relapsed or refractory: Reference
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