Zanubrutinib Plus R-CHOP Effective for Non-GCB DLBCL With Extranodal Involvement

Zanubrutinib plus rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) was safe and effective in treatment-naïve patients with non–germinal center B cell–like (non-GCB) diffuse large B-cell lymphoma (DLBCL) with multiple extranodal involvement, according to study results published in Frontiers in Immunology.

A poor response with R-CHOP is common in patients with non-GCB DLBCL with extranodal involvement, explained researchers from the National Clinical Research Center for Hematologic Diseases in Jinan, China. The single-arm, phase 2, prospective study looked at the effect of zanubrutinib with R-CHOP (ZR-CHOP) in 26 newly diagnosed patients between October 2020 and March 2022. Patients received ZR-CHOP for six cycles, followed by two cycles of rituximab and zanubrutinib for maintenance treatment.

Among 23 patients evaluated for efficacy after three cycles of ZR-CHOP, the rate of progression-free survival was 80.8%, and the overall survival rate was 88.5%, at 1 year. Progression-free survival and overall survival rates at 2 years are expected to be 74% and 88.5%, respectively, according to the study. The overall response rate was 91.3%.

Next-generation sequencing of 20 patients detected several oncogenic mutations closely related to DLBCL pathogenesis, researchers reported.

“B-cell receptor and NF-κB pathway gene mutations were detected in 10 patients,” they wrote, “which occurred in MYD88 (7/19), CD79B (4/19), CARD11 (5/19), and TNFAIP3 (2/19).”

Grade 3 or higher adverse events included neutropenia, thrombocytopenia, anemia, and pulmonary infection.

Reference:
Hongzhi G, Sixun J, Ying Z, et al. Efficacy and safety of zanubrutinib plus R-CHOP in treatment of non-GCB DLBCL with extranodal involvement. Frontiers in Immunology. 2023;14. doi:10.3389/fimmu.2023.1219167