VIDEO: Considerations when treating relapsed, refractory DLBCL

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Diffuse large B-cell lymphoma is the most common form of lymphoma, but despite very good front-line treatment, about a third of patients will have relapsed or refractory disease, meaning they never enter remission. And in those circumstances, the best treatment option is to move toward, usually, cellular therapy with CAR T-cell treatment, particularly in those patients who are chemo refractory, not in remission for more than a year after treatment. In some circumstances, if the remission is long and the recurrence takes years to occur, then autologous stem cell transplant is still a proven treatment strategy that can produce durable remissions or cures in a large proportion of patients. And in those cases, typically second-line chemotherapies are usually administered in order to get into a better remission prior to moving toward stem cell transplant. And the question about whether to use, so-called salvage, your second-line treatment prior to CAR T-cell therapy is sort of an ongoing question. In a practical matter, it oftentimes is necessary to obtain disease control rapidly in order to allow for time for the logistics of insurance authorization and arrangement for leukapheresis, and then manufacturing of cell therapy. And that whole process can take several weeks, maybe even a month or 2. So, oftentimes second-line treatment is needed in those cases.