Certain Subtypes of DLBCL Respond Better to Ibrutinib Plus R-CHOP

According to a recent article from Hematology Advisor, a study shows patients diagnosed with particular subtypes of diffuse large B-cell lymphoma (DLBCL) respond better to ibrutinib with R-CHOP compared to just R-CHOP.

Diffuse Large B-Cell Lymphoma (DLBCL)

Diffuse large B-cell lymphoma (DLBCL) is the most common form of non-Hodgkin’s lymphoma, with more than 18,000 people being diagnosed every year. B-lymphocytes are affected in this aggressive cancer. 

This cancer can occur in any place throughout the body and affect people of any age, but it is most likely to affect the lymph nodes in those over the age of 60. 


The most common symptom is painless swelling of the lymph nodes, which can occur in many places throughout the body and grow quickly. Other symptoms include night sweats, fevers, unintentional weight loss, and itching.

If the cancer has spread, other symptoms may occur depending on the affected organs. For example, DLBCL that has spread to the abdomen can cause effects like pain, diarrhea, and bleeding. 

The Phase 3 PHOENIX Trial Analysis

Results from the phase 3 PHOENIX trial showed that all the genetic subtypes of DLBCL have different responses to treatment. Patients diagnosed with DLBCL with an ABC gene expression subtype have showed better survival rates when treated with ibrutinib.

In order to come to this conclusion, researchers looked at biopsies from patients in the PHOENIX trial. Out of the 838 patients in the study, researchers looked at tumors from 773 of the patients. They found that patients who are over 60-years-old experience increased toxicity from ibrutinib, and therefore there are no benefits of using it regardless of subtype. On the other hand, younger patients with certain subtypes benefited greatly.

Younger patients with an MCD subtype proved to have 100% event-free survival (EFS) and overall survival (OS) after 3 years when being treated with ibrutinib plus R-CHOP (rituximab, cyclophosphamide, doxorubicin hydrochloride, vincristine sulfate, and prednisone). Patients who only received R-CHOP had an EFS of 48% and an OS of 69.9%. Furthermore, patients diagnosed with N1 DLBCL had an EFS and OS of 100% after 3 years in comparison to 50% EFS and OS when using R-CHOP by itself.

Researchers concluded that patients under 60 years old with certain subtypes of DLCBL benefit from being treated with ibrutinib plus R-CHOP.

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