Patients with diffuse large B-cell lymphoma (DLBCL) who have relapsed continue to have a dismal prognosis with available treatments. For patients with relapsed or refractory DLBCL, researchers prospectively assessed the combination of pixantrone and obinutuzumab for up to 6 cycles.

The main measure of success was the overall response rate (ORR). About 68 patients were examined; their median age was 75; the median number of previous lines was 3 (range: 1–10); 52 patients (76.5%) had DLBCL; 16 (23.5%) had follicular lymphoma (FL) IIIB or an indolent lymphoma that had changed. The median progression-free survival (PFS) and overall survival (OS) were 2.8 months and 8 months, respectively. The ORR was 35.3% for all patients and 40% for those that were analyzed (16.6% complete response).

Patients with a non-GCB (germinal center B-cell-like) phenotype had a better prognosis, according to an analysis of the cell of origin [median OS not attained (n.r.) vs. 5.2 months]. Patients treated in an earlier line had better results than those treated in subsequent lines (PFS n.r. vs. 2.5 months). Premature termination was mostly caused by disease progression. The majority of adverse events were hematologic. No unanticipated negative side effects of the combo therapy were found. Infection was the most significant non-haematologic harm in 28% of patients.

In conclusion, pixantrone-obinutuzumab demonstrated clinical activity with occasional long-term remission; however, the trial’s primary endpoint was not reached.

Reference: onlinelibrary.wiley.com/doi/10.1111/bjh.18161