Comparing and Ranking Targeted Therapies for Patients with Diffuse Large B-Cell Lymphoma

Researchers, led by Jie Wang, MD, MS, conducted a network meta-analysis of randomized controlled trials to compare targeted treatment options for patients with diffuse large B-cell lymphoma (DLBCL). Their report, published in BMC Cancer, found that adding dacetuzumab to rituximab-based regimens or lenalidomide provided more favorable overall survival (OS) outcomes; adding either dacetuzumab or bortezomib to rituximab was associated with improved event-free survival (EFS) rates, and receiving lenalidomide or I-tositumomab yielded a relatively high overall response rate (ORR).

The study included a total of 18 trials, comprising 8,207 patients with DLBCL. Researchers d treatment options directly and indirectly. The investigators used a random-effects model to compare the incidences of grade III or higher adverse events after either targeted therapies or chemotherapy.

Based on surface under the cumulative ranking (SUCRA) probabilities, adding dacetuzumab (74.8%) to rituximab-based regimens or lenalidomide (77.1%) had the greatest association with better effects on OS in patients with DLBCL. Comparatively, dacetuzumab (80.4%) or bortezomib (70.8%) added to rituximab was the most likely option for improving EFS. Further, lenalidomide (93.8%) and I-tositumomab (77.2%) were associated with higher overall response rates.

Dr. Wang and colleagues also observed that patients received targeted therapies had an increased risk of diarrhea (risk ratio [RR] = 2.63; 95% confidence interval [CI], 1.18–5.86; p = 0.019) and thrombocytopenia (RR = 1.41; 95% CI, 1.05–1.90; p = 0.023), compared to patients receiving traditional chemotherapy regiments.

The authors concluded that their study’s findings elucidated the best options for improving OS, EFS, or ORR during the treatment patients with DLBCL, though they noted that their results require validation in future studies.