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@ARTICLE{Alig:305508,
author = {S. K. Alig$^*$ and A. Reinhardt$^*$ and B. von
Tresckow$^*$},
title = {{W}hat is established in the treatment of diffuse large
{B}-cell lymphoma? [{W}as ist gesichert in der {T}herapie
des diffusen großzelligen {B}-{Z}ell-{L}ymphoms?]},
journal = {Die Innere Medizin},
volume = {nn},
issn = {2731-7080},
address = {Berlin},
publisher = {Springer Medizin},
reportid = {DKFZ-2025-02192},
pages = {nn},
year = {2025},
note = {epub},
abstract = {Diffuse large B‑cell lymphoma (DLBCL) is the most common
aggressive non-Hodgkin lymphoma, with a median age at
diagnosis of 71 years, predominantly affecting older adults.
Risk factors include immunodeficiency, autoimmune disorders,
viral infections, and certain environmental exposures,
although most cases lack a clear predisposition. Diagnosis
is based on lymph node excision, histopathological and
molecular analysis, and positron emission
tomography-computed tomography (PET-CT) staging. First-line
standard therapy is R‑CHOP (rituximab, cyclophosphamide,
doxorubicin, vincristine, prednisone), de-escalated to four
cycles for young, low-risk patients (FLYER trial). For
patients with International Prognostic Index (IPI) ≥ 2,
the POLARIX trial showed superior progression-free survival
with polatuzumab vedotin-R-CHP (rituximab, cyclophosphamide,
doxorubicin, prednisone) over R‑CHOP. Older patients are
generally treated with dose-reduced R‑mini-CHOP or
alternatives. In relapsed/refractory disease, chimeric
antigen receptor (CAR) T‑cell therapy with axicabtagene
ciloleucel or lisocabtagene maraleucel has replaced
high-dose chemotherapy with autologous stem cell
transplantation for refractory or early relapses, including
transplant-ineligible patients. Additional antibody-based
therapies-such as polatuzumab-bendamustine-rituximab,
tafasitamab-lenalidomide, loncastuximab, and bispecific
antibodies (glofitamab, epcoritamab, odronextamab)-expand
treatment options, some achieving durable remissions.
Glofitamab plus gemcitabine-oxaliplatin is a new standard
for first relapse when CAR T‑cell therapy is not feasible
or as bridging before CAR T. Future directions include
earlier integration of immunotherapies, personalized
strategies guided by genetic subgroups, and broader use of
liquid biopsy for subtyping, minimal residual disease
detection, and treatment guidance.},
subtyp = {Review Article},
keywords = {Antibodies, bispecific (Other) / CAR T‑cell therapy
(Other) / CHOP protocol (Other) / Lymphoma, non-Hodgkin
(Other) / Rituximab (Other)},
cin = {ED01},
ddc = {610},
cid = {I:(DE-He78)ED01-20160331},
pnm = {899 - ohne Topic (POF4-899)},
pid = {G:(DE-HGF)POF4-899},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:41125821},
doi = {10.1007/s00108-025-01999-x},
url = {https://inrepo02.dkfz.de/record/305508},
}