Abstract
While CHOP has been the standard treatment for DLBL, the low cure rate of approximately 40% implies that there is a need for improvement. Several hypotheses have been tested to optimize treatment. The Goldie and Coldman hypothesis sustains that drug resistance is a function of tumor burden and, accordingly, third generation regimens were designed. A randomized trial comparing CHOP with them showed no difference in the outcome. The myeloablative dose-intensity has become established as the best salvage therapy currently available for chemosensitive relapse of DLBL. However when tested as a frontline therapy clear results have not been obtained. The Norton and Simon hypothesis is based in Gompertzian kinetics whereby the growth rate of smaller tumors is higher. Thus, the dosedense concept emerges, shortening the intervals between cycles and lowering tumor regrowth with CHOP-14 has recently been shown to improve the outcome in patients with DLBL. Addition of Rituximab-based immunotherapy is being tested in ongoing trials. Other approaches to optimize the treatment are based on a dynamic decision following early responses based on new imaging techniques. Finally, the analysis of tissue arrays and genomic profiling, which provide insights into the oncogenic pathways involved, is allowing the development of new targets.
Keywords: Diffuse large B-cell lymphomas, treatment, chemotherapy, biological therapy, new targets
Reviews on Recent Clinical Trials
Title: New Treatment Concepts In Diffuse Large B-Cell Lymphomas (DLBL): Chemotherapy and Biological Therapy
Volume: 2 Issue: 2
Author(s): Jose Rodriguez and Antonio Gutierrez
Affiliation:
Keywords: Diffuse large B-cell lymphomas, treatment, chemotherapy, biological therapy, new targets
Abstract: While CHOP has been the standard treatment for DLBL, the low cure rate of approximately 40% implies that there is a need for improvement. Several hypotheses have been tested to optimize treatment. The Goldie and Coldman hypothesis sustains that drug resistance is a function of tumor burden and, accordingly, third generation regimens were designed. A randomized trial comparing CHOP with them showed no difference in the outcome. The myeloablative dose-intensity has become established as the best salvage therapy currently available for chemosensitive relapse of DLBL. However when tested as a frontline therapy clear results have not been obtained. The Norton and Simon hypothesis is based in Gompertzian kinetics whereby the growth rate of smaller tumors is higher. Thus, the dosedense concept emerges, shortening the intervals between cycles and lowering tumor regrowth with CHOP-14 has recently been shown to improve the outcome in patients with DLBL. Addition of Rituximab-based immunotherapy is being tested in ongoing trials. Other approaches to optimize the treatment are based on a dynamic decision following early responses based on new imaging techniques. Finally, the analysis of tissue arrays and genomic profiling, which provide insights into the oncogenic pathways involved, is allowing the development of new targets.
Export Options
About this article
Cite this article as:
Rodriguez Jose and Gutierrez Antonio, New Treatment Concepts In Diffuse Large B-Cell Lymphomas (DLBL): Chemotherapy and Biological Therapy, Reviews on Recent Clinical Trials 2007; 2 (2) . https://dx.doi.org/10.2174/157488707780599348
DOI https://dx.doi.org/10.2174/157488707780599348 |
Print ISSN 1574-8871 |
Publisher Name Bentham Science Publisher |
Online ISSN 1876-1038 |
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
Related Articles
-
Applications of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration (EBUS-TBNA) in Pulmonary Disease
Current Respiratory Medicine Reviews Rethinking Pharmacogenomics Education Beyond Health Professionals: Addressing the “Know-Do” Gap Across the Personalized Medicine Innovation Ecosystem
Current Pharmacogenomics and Personalized Medicine Resistance to Anti-VEGF Agents
Current Pharmaceutical Design Ribonucleases and ImmunoRNases as Anticancer Drugs
Current Pharmaceutical Design The Rational Design of Anticancer Platinum Complexes: The Importance of the Structure-Activity Relationship
Current Medicinal Chemistry MicroRNAs as Regulators in Normal Hematopoietic and Leukemia Stem Cells: Current Concepts and Clinical Implications
Current Molecular Medicine Vascular Endothelial Growth Factor (VEGF) as a Target of Bevacizumab in Cancer: From the Biology to the Clinic
Current Medicinal Chemistry Preclinical and Clinical Studies of Novel Breast Cancer Drugs Targeting Molecules Involved in Protein Kinase C Signaling, the Putative Metastasis-Suppressor Gene Cap43 and the Y-box Binding Protein-1
Current Medicinal Chemistry Advances in the Development of Multimodal Imaging Agents for Nuclear/Near-infrared Fluorescence Imaging
Current Medicinal Chemistry Cell Arrest and Apoptosis Induced by the Next Generation of Vanadium Based Drugs: Action Mechanism to Structure Relation and Future Perspectives
Anti-Cancer Agents in Medicinal Chemistry New Anticancer Drugs from Marine Cyanobacteria
Current Drug Targets Mechanisms of Resistance to Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors in Patients with Advanced Non-Small-Cell Lung Cancer: Clinical and Molecular Considerations
Current Medicinal Chemistry Selective Cytotoxic Effects of 5-Trifluoromethoxy-<i>1H</i>-indole-2,3-dione 3-Thiosemicarbazone Derivatives on Lymphoid-originated Cells
Anti-Cancer Agents in Medicinal Chemistry Natural and Synthetic Furanocoumarins as Treatment for Vitiligo and Psoriasis
Current Drug Therapy Biological Applications of the Receptor Mimetic Peptide Mastoparan
Current Protein & Peptide Science ISCHEMIRs: Finding a Way Through the Obstructed Cerebral Arteries
Current Drug Targets Bioactive Compounds Containing Benzoxadiazole, Benzothiadiazole, Benzotriazole
Current Bioactive Compounds Pharmacogenetic Aspects of Drug Metabolizing Enzymes in Busulfan Based Conditioning Prior to Allogenic Hematopoietic Stem Cell Transplantation in Children
Current Drug Metabolism CD44 - a New Cardiovascular Drug Target or Merely an Innocent Bystander?
Cardiovascular & Hematological Disorders-Drug Targets High Order Texture-Based Analysis in Biomedical Images
Current Medical Imaging