Experts look to new treatment beyond chemo for large B-cell Lymphoma

There are primarily two categories of lymphomas, Hodgkin’s Lymphoma and Non-Hodgkin’s Lymphoma. Out of the two, Non-Hodgkin’s Lymphoma is the most common, while Hodgkin’s Lymphoma accounts for about 1% of lymphomas worldwide. The age-adjusted incidence rates for Non-Hodgkin’s Lymphoma in men and women in India are 2.9/100,000 and 1.5/100,000, respectively. The type of NHL is called by the name of the cells they affect.

B cell lymphoma or diffuse large B-cell lymphoma (DLBCL) for example, is the cancer of the B cells responsible for producing antibodies. It is the most common subtype of NHL, constituting about 40% of NHL lymphoma cases worldwide.  More than 18,000 people are diagnosed with it every year only in the USA. The survival rate of B cell lymphoma after diagnosis increases up to 80-90% each year after treatment.

The best cancer treatment for DLBCL to date is a regimen of chemotherapy. However, cancer specialists and the best cancer doctors worldwide are always looking for better options or at least different options. Here we’ll talk about just that.

The current DLBCL treatments options

Even the best oncologist in Delhi NCR or in your hometown will tell you that for DLBCL, chemotherapy has been the norm for a long time. A chemotherapy drug combination called R-CHOP is commonly used for DLBCL patients in different aggregates based on the staging. In this combination, R is for Rituximab, C is for Cyclophosphamide, H is for Doxorubicin Hydrochloride (Hydroxydaunomycin), and O is for Vincristine Sulfate (Oncovin). The success rate of R-CHOP is very high at 60-80%, but the side effects can be severe in some people.

The common side effects of it are:

• Nausea
• Vomiting
• Weight Loss
• Hair Loss
• Irritability
• Fatigue
• Indigestion

Another slower approach is taken by cancer specialists called adjusted EPOCH-R, a more intensive cancer treatment. EPOCH-R stands for etoposide phosphate, prednisone, Oncovin, Cytoxan and Adriamycin plus Rituxan, according to cancer specialists. Some of the best cancer doctors can choose to offer EPOCH-R instead of R-CHOP to people who have a higher international prognostic index score.

Promising DLBCL treatment options

A respected lymphoma cancer doctor in Noida or any other place, like Dr. Manish Singhal, will tell you that lymphoma patients and cancer specialists worldwide are finding more hope in different novel treatment options being developed by researchers.

Another new treatment option is CAR-T therapy. Kymriah (tisagenlecleucel) and Yescarta (axicabtagene ciloleucel) are the FDA approved CAR-T therapies currently in use by cancer specialists treating different stages of DLBCL. This is considered to be one of the best cancer treatments by cancer specialists worldwide because the survival rate increased dramatically with its use. It is recorded that for 40% of the patients who got cured with this treatment, life expectancy will be normal.

The truth about this treatment option is that some of the best cancer doctors believe that this therapy can be so effective in certain cases that it can be used instead of high-dose chemotherapy followed by stem cell transplant. In fact, cancer specialists believe that if CAR-T can beat stem-cell therapy, it could be used as a second line of treatment.

Then, according to cancer specialists and researchers, there are some experimental drugs called bi-specific T-cell engagers or BiTEs, which are off-the-shelf and do not require individualistic testing. No laboratory manipulation means no delay in treatment. A recent clinical trial in which 47 patients with new diagnoses who either did not respond to R-CHOP or relapsed soon after treatment were given a BiTE drug called blinatumomab. 89% of them responded partially or completely to the drug. This is great news because such groups were previously recorded to have low survival rates. Another BiTE being studies is mosunetuzumab. Many of the patients previously treated with it went into complete remission.

XPOVIO® (selinexor) is the first and only single-agent oral therapy used for the treatment of patients with relapsed or refractory diffuse large b-cell lymphoma (DLBCL). This is another new addition to the entourage of new discoveries for DLBCL.

Looking at the postscript

Some of the treatments mentioned above will go on to become the best cancer treatments available for people suffering from DLBCL, while others might eventually fizzle out. The important thing to note is that these treatments have a great potential of becoming the next best cancer treatment. So, if you or any of your loved ones suffer from DLBCL, you should know about these advancements. The only way to do that and understand the implications is to consult an experienced cancer specialist like Dr. Manish Singhal, a top cancer treatment doctor in Delhi NCR.