A breakthrough treatment is achieving full remissions.
Researchers have reported promising results from an experimental cancer treatment approach for aggressive B-cell lymphoma, achieving complete remissions in some patients without using chemotherapy.
The treatment regimen, named ViPOR for its combination of five drugs — venetoclax, ibrutinib, prednisone, obinutuzumab, and lenalidomide — targets multiple molecular pathways crucial for diffuse large B-cell lymphoma (DLBCL) tumor survival. DLBCL is the most common form of lymphoma, a cancer affecting the body’s immune system.
Led by Dr. Christopher Melani from the National Cancer Institute (NCI), the clinical trial involved 50 patients with DLBCL facing poor prognoses, either due to relapsed cancers or lack of response to standard therapies.
“Many of these patients, who had stopped responding to conventional treatments, would typically have died within a year. Now, a significant proportion are alive beyond two years, with some surpassing four years,” noted Melani.
The ViPOR regimen administered the drugs simultaneously in cycles lasting two weeks, with a weeklong break between cycles. Results showed substantial tumor shrinkage in 54% of evaluated patients, with 38% achieving complete tumor disappearance.
By the two-year mark, 36% of all patients were still alive, and 34% were disease-free. The treatment’s efficacy was notably pronounced in specific DLBCL subtypes, highlighting its potential to target diverse genetic variations within the cancer.
“DLBCL exhibits significant genetic variability, making it challenging to determine the optimal drug combination for each patient,” Melani explained in an NCI statement. “However, the synergy of five drugs in ViPOR suggests that various combinations can effectively combat specific tumor profiles.”
The trial revealed particularly favorable outcomes in patients with non-GCB DLBCL and high-grade B-cell lymphoma double-hit subtypes, where 62% and 53% respectively achieved complete responses after six cycles of ViPOR.
Moreover, ViPOR proved beneficial for 30% of patients previously unresponsive to or relapsed after CAR T-cell therapy, a standard treatment using the patient’s own T-cells to fight cancer.
Side effects from ViPOR were generally mild to moderate compared to standard treatments, prompting researchers to consider additional drug combinations for enhanced efficacy.
Ongoing studies are now focusing on expanding ViPOR’s application to other treatment-resistant lymphomas, with plans for a larger phase 2 trial to validate initial findings. Future research aims to refine therapies for DLBCL subtypes less responsive to current treatments, emphasizing the need for personalized medicine approaches in cancer care.
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