[PDF][PDF] Effect of ibrutinib with R-CHOP chemotherapy in genetic subtypes of DLBCL

WH Wilson, GW Wright, B Hodkinson… - Cancer cell, 2021 - cell.com
WH Wilson, GW Wright, B Hodkinson, S Balasubramanian, Y Fan, J Vermeulen, M Shreeve…
Cancer cell, 2021cell.com
In diffuse large B cell lymphoma (DLBCL), tumors belonging to the ABC but not GCB gene
expression subgroup rely upon chronic active B cell receptor signaling for viability, a
dependency that is targetable by ibrutinib. A phase III trial (" Phoenix;" ClinicalTrials. gov:
NCT01855750) showed a survival benefit of ibrutinib addition to R-CHOP chemotherapy in
younger patients with non-GCB DLBCL, but the molecular basis for this benefit was unclear.
Analysis of biopsies from Phoenix trial patients revealed three previously characterized …
Summary
In diffuse large B cell lymphoma (DLBCL), tumors belonging to the ABC but not GCB gene expression subgroup rely upon chronic active B cell receptor signaling for viability, a dependency that is targetable by ibrutinib. A phase III trial ("Phoenix;" ClinicalTrials.gov: NCT01855750) showed a survival benefit of ibrutinib addition to R-CHOP chemotherapy in younger patients with non-GCB DLBCL, but the molecular basis for this benefit was unclear. Analysis of biopsies from Phoenix trial patients revealed three previously characterized genetic subtypes of DLBCL: MCD, BN2, and N1. The 3-year event-free survival of younger patients (age ≤60 years) treated with ibrutinib plus R-CHOP was 100% in the MCD and N1 subtypes while the survival of patients with these subtypes treated with R-CHOP alone was significantly inferior (42.9% and 50%, respectively). This work provides a mechanistic understanding of the benefit of ibrutinib addition to chemotherapy, supporting its use in younger patients with non-GCB DLBCL.
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