UCLI02 | STATE‐OF‐THE‐ART OF LIQUID BIOPSY IN LYMPHOMA

Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of lymphoma and a group of highly heterogeneous diseases.Although the standard R-CHOP regimen can cure 50%-60% of DLBCL patients, 40%-50% of patients still experience relapse and refractory disease.These patients urgently need new treatment strategies to address the issue of long-term survival.In recent years, Chinese scholars have made numerous attempts in this area and achieved fruitful results.This article briefly introduces the results of several latest clinical studies.DEB is the first phase III trial to confirm the benefit of Tucidinostat plus R-CHOP in previously untreated diffuse large Bcell lymphoma with double expression of MYC and BCL2 (ED).423 patients were enrolled at 40 study centers in mainland China and randomly assigned 211 to tucidinostat group and 212 to placebo group.The 24-month EFS rate was 58.9% (95% CI: 48.9-67.6) in the tucidinostat group and 46.2% (95% CI: 35.7-56.1) in the placebo group.The hazard ratio (HR) between the two groups was 0.68 (95% CI: 0.49-0.94),with a p-value of 0.018.At the completion of combination treatment, the CRR in the tucidinostat and placebo groups were 73.0%(95% CI: 66.6-78.5)and 61.8% (95% CI: 55.1-68.1),respectively.The adjusted difference in CRR was 11.1% (95% CI: 2.3-20.0;p = 0.014).The DEB study is the first phase III trial to show that combining tucidinostat with R-CHOP regimen is a feasible and efficacious novel approach in previously untreated DLBCL patients with DE.Tucidinostat plus R-CHOP c had been approved in China for the treatment of patients with DE.Elderly patients with DLBCL cannot tolerate standard chemotherapy, have a poor prognosis and a short survival period.Chinese scholars have also made beneficial attempts in this regard.A prospective, phase II, multi-center study to explore the efficacy and safety of polatuzumab vedotin plus rituximab and lenalidomide(Pola-R 2 ) in treatment-naive patients ≥ 70 years old and defined as unfit or frail (named non-fit).Twenty-one patients were enrolled in this study.Median age was 79.5 years (range: 73-90) with four patients defined as frail.The CRR after 4 cycles of Pola-R 2 regimen were 92.9%.Eight patients had continuous monitor of ctDNA and all of them reached an undetected minimal residual disease at a level of 10 -4 (uMRD4) after cycle4.Pola-R 2 regimen was highly effective and safe in previously untreated non-fit elderly DLBCL patients.Results of this trial are worth expecting.Another study also shows promising prospects: polatuzumab vedotin, zanubrutinib, rituximab, and lenalidomide (Pola-ZR2) regimen in unfit or frail patients with DLBCL, the CR rate was 77% (17/22), and ORR was 86% (19/22).The Pola-ZR2 regimen demonstrates promising efficacy in unfit or frail patients with DLBCL.More clinical research results will be presented at this meeting.