Pooja Biraia
Diffuse Large B-Cell Lymphoma (DLBCL), the most aggressive form of non-Hodgkin lymphoma (NHL), is a completely curable disease, says Dr S P Sanyal, senior consultant and hemat oncologist at Mumbai's Fortis Hospital.
However, he added that while 60 per cent of patients get cured of it, the remaining 40 per cent see a high chance of a relapse. "Two years post-treatment are very crucial. If until that time, the patient manages his or her condition well and there is no sign of a relapse, we can safely say that the patient is cured."
The understanding of DLBCL has undergone a "tremendous shift," in the last two decades, say experts. Oncologists THE WEEK spoke to agreed that it is now that they've begun to understand this lymphoma much better. So much so that their knowledge of disease biology has become much better and more advanced than it was in 2010. For example, now it is established that this type of lymphoma is definitely not a genetic one and that if 10 patients suffer from DLBCL, three to four of them will die of a relapse, say experts.
Lymphoma is the most common type of blood cancer that accounts for around 25,000 new cases annually in India. In a recent press conference, Dr Sanyal spoke about an FDA-approved therapy for first-line treatment of DLBCL - the use of Polatuzumab, a new drug, in combination with chemotherapy - now available in India - which will offer patients access to cutting-edge care and the potential for improved outcomes. This is the first FDA-approved therapy for the first-line treatment of DLBCL.
Polatuzumab is a first-in-class anti-CD79b antibody-drug conjugate (ADC). Data from Polatuzunab trial data indicates a significant reduction of 27% in risk of progression-free survival, disease progression, relapse or death compared to the existing standard-of-care of MabThera/Rituxan plus cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP), say experts. Since the adoption of chemotherapy in 2002, approximately 11 clinical trials have failed to demonstrate improved clinical outcomes for DLBCL. Polatuzumab’s success is a remarkable breakthrough.
"The problem is many patients undertake the wrong means of treatment through self-medication, such as consuming pills meant for treating tuberculosis as a way of treating the DLBCL lymphoma. Add to that the problem of delayed diagnosis and the situation looks bleak. We mostly see this type of lymphoma in two clear age groups, viz 10 to 20 and 50 to 70. Last year I treated about seven to eight cases of children and young adults in the 10 to 20 age bracket. Now, with this new treatment regimen, the chances of a patient dying from DLBCL will reduce by up to 27% compared to the current treatment option. In my observation so far, 77% of patients who got the new treatment did not show any worsening of the disease after 2 years of having been on this therapy, said Sanyal.
The best chance of preventing relapse in people with DLBCL is with effective and tolerable therapy at a time when patients are first diagnosed and have received no prior treatment before the diagnosis is made. Polatuzumab, an antibody-drug conjugate (ADC), offers hope for such patients by targeting specific proteins on lymphoma cells and delivering cytotoxic agents directly to the cancer cell, say experts.