VIDEO: Research working to improve outcomes in high-risk DLBCL

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At this point, there are at least several trials looking at improving outcomes in some of these higher-risk, poor-outcomes patients, so there are trials that are looking at moving the bispecific antibodies, which are the CD20, CD3 bispecifics and combining them with chemotherapy in the frontline setting. There are actually three trials at this point. There is a study looking at odronextamab (REGN1979; Regeneron) in the frontline setting, which is a CD20, CD3. There's a study looking at epcoritamab (Epkinly; Genmab, AbbVie) plus R-CHOP in the front line setting. Then there was an upcoming study looking at glofitamab (RG6026; Genentech) plus R-CHOP Pola versus R-CHOP Pola in its frontline setting. And then there as well is a high-risk study looking at CAR-T in the frontline setting where patients are allowed to get a cycle of chemotherapy and then proceed to receive the CAR-T product if they have high risk features. So, I would say these are the most exciting things, at least in the frontline setting.

Second line setting, at this point, CAR-T was pretty much entrenched, or it should be. There are newer CAR-T products coming out, looking at different targets, dual CARs looking at targeting multiple epitopes to try to overcome some of the resistance. There are other bispecific antibodies in third line and beyond, and there are combination trials with the bispecific with other targeted treatments, mostly ADCs, which are antibody drug conjugates, trying to improve outcomes in this patient population, so a lot of these trials are moving forward and moving along. I would say these are probably the most exciting things as of right now, in large cell lymphoma. There are some new ADCs that are coming along, targeting different epitopes, and there are other new drugs in this patient population because, again, unfortunately, for those who relapse, especially those refractory patients, they tend to burn through treatments, so there are always new treatments that are coming along the way. A lot of the other ones are still too early in clinical practice to really know how they'll impact clinical outcomes.