Multicenter phase 2 trial of zanubrutinib, lenalidomide plus R-CHOP for non-GCB diffuse large B-cell lymphoma

Patients with non-germinal center B-cell-like diffuse large B-cell lymphoma (non-GCB DLBCL) often have suboptimal responses to standard R-CHOP therapy. A multicenter phase 2 trial in China evaluated addition of zanubrutinib and lenalidomide to 6 cycles of R-CHOP (‘ZR2-CHOP’) for newly diagnosed non-GCB DLBCL. Among 34 enrolled patients, median age was 55 years, with 29.4% over 60 years. The best overall response rate was 100%. Complete response was achieved in 70.6% of patients at mid-treatment and 94.1% at end of treatment. With a median follow-up of 28 months, the 2-year progression-free survival rate was 84.8% and the 2-year overall survival rate was 96.8%. Grade 3 or 4 adverse events occurred in 67.6% of patients; primarly hematologic toxicities. The authors conclude that ZR2-CHOP demonstrated promising efficacy and manageable toxicity in newly diagnosed non-GCB DLBCL (visual abstract).