Peter Riedell, MD, on DLBCL: Expert Commentary on the DEB Study
2024 ASCO Annual Meeting
Peter Riedell, MD, of The University of Chicago, discusses phase III results on the use of tucidinostat plus R-CHOP in patients with previously untreated diffuse large B-cell lymphoma (DLBCL) with double expression of MYC and BCL2. The regimen appeared to improve event-free survival and complete response rates vs R-CHOP in the front-line setting. As this is an interim analysis, longer-term follow-up will be needed to better understand its impact, says Dr. Riedell.
Transcript
Disclaimer: This video transcript has not been proofread or edited and may contain errors.
The DEB study was a phase three clinical trial that was recently presented at the ASCO meeting. This study evaluated the combination of R-CHOP with HDAC inhibitor, Tucidinostat. In this trial, it was conducted exclusively in China and it enrolled patients in the frontline setting that had double expressor lymphoma.
Double expressor lymphoma is the specific subset of diffuse large B-cell lymphoma that shows increased expression of both MIC and BCL2 without the associated gene rearrangements. In this clinical trial, patients were randomized to either placebo or Tucidinostat in combination with R-CHOP, and they received that for six cycles and then went on to receive either maintenance therapy with Tucidinostat or placebo. The combination of Tucidinostat and R-CHOP in this clinical trial actually yielded increased CR rates compared to R-CHOP therapy alone, and additionally, this translated into an event-free survival benefit as well. Though there's only a short follow-up of approximately 13.9 months median at this point, and therefore we need longer followup to get a better understanding of outcomes.
Importantly, this study did not show a difference in overall survival at this point. The combination of Tucidinostat and R-CHOP was relatively well tolerated, though we did see a higher incidence of hematologic toxicity along with infectious complications compared to R-CHOP therapy alone.
This is overall my take on this is it's encouraging data, but we do need to have longer term followup. Additionally, questions do still remain regarding if this data is applicable to non-Asian populations, what's the impact of maintenance therapy in this clinical trial that was employed, and then, additionally, how do these results really compare to one of the other standards of care that we use in diffuse large B-cell lymphoma, which is Polatuzumab RCHP.
The ASCO Post Staff
Ana C. Garrido-Castro, MD, of Dana-Farber Cancer Institute, reports the results from the phase II SACI-IO trial in patients with hormone receptor–positive/HER2-negative metastatic breast cancer who received sacituzumab govitecan-hziy with or without pembrolizumab (LBA1004).
The ASCO Post Staff
Fabrice Andre, MD, PhD, of Gustave Roussy and the Université Paris-Saclay, discusses a dose-expansion interim analysis of trastuzumab deruxtecan (T-DXd) monotherapy and T-DXd plus pertuzumab in patients with previously untreated HER2-positive metastatic breast cancer (Abstract 1009).
The ASCO Post Staff
Mostafa Eyada, MD, of The University of Texas MD Anderson Cancer Center, discusses study results showing that bevacizumab in combination with oral cyclophosphamide had a response rate of 40% in patients with recurrent platinum-resistant high-grade ovarian cancer (Abstract 5517).
The ASCO Post Staff
Laurence Albiges, MD, PhD, of Gustave Roussy, Université Paris-Saclay, discusses phase III findings showing that high baseline serum KIM-1 levels were associated with poorer prognosis but improved clinical outcomes with atezolizumab vs placebo in patients with renal cell carcinoma at increased risk of recurrence after resection. Increased post-treatment KIM-1 levels were found to be associated with worse disease-free survival (Abstract 4506).
The ASCO Post Staff
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