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.
Related Videos
The ASCO Post Staff
Thierry Facon, MD, of the University of Lille and Lille University Hospital, discusses phase III findings showing for the first time that isatuximab, an anti-CD38 monoclonal antibody, when given with the standard of care (bortezomib, lenalidomide, dexamethasone, or VRd) to patients with newly diagnosed multiple myeloma who are transplant-ineligible, may reduce the risk of disease progression or death by 40.4% vs VRd alone (Abstract 7500).
The ASCO Post Staff
Minesh P. Mehta, MD, of Miami Cancer Institute, part of Baptist Health South Florida, discusses results from the METIS (EF-25) trial evaluating the efficacy and safety of tumor treating fields therapy following stereotactic radiosurgery in patients with mutation-negative non–small cell lung cancer (NSCLC) and brain metastases. Tumor treating fields therapy prolongs time to intracranial disease progression and may postpone whole-brain radiation therapy without declines in quality of life and cognition (Abstract 2008).
The ASCO Post Staff
Brian I. Rini, MD, of Vanderbilt Ingram Cancer Center, discusses phase III findings of the KEYNOTE-426 study of pembrolizumab plus axitinib vs sunitinib for patients with advanced renal cell carcinoma. He details the exploratory biomarker results, including RNA sequencing, whole-exome sequencing, and PD-L1 (Abstract 4505).
The ASCO Post Staff
Jeanne Tie, MD, MBChB, of Peter MacCallum Cancer Centre, discusses data on survival and updated 5-year results from the DYNAMIC trial, which supports a role for circulating tumor DNA (ctDNA) analysis, including serial sampling, in the management of patients with stage II colon cancer (Abstract 108).
The ASCO Post Staff
Yeon Hee Park, MD, PhD, of South Korea’s Samsung Medical Center and Sungkyunkwan University, discusses phase II findings on palbociclib plus exemestane with a GnRH agonist vs capecitabine in premenopausal patients with hormone receptor–positive, HER2-negative metastatic breast cancer (LBA1002).