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Everything in development, the medicines held by this cancer's subtypes, the open problems and what is being done about them, the roadmaps, and what changed on this record.
What is in development for Diffuse large B-cell lymphoma, drawn from the whole corpus: 159 items. Drugs are grouped by the most advanced trial phase they have reached anywhere; approved treatments sit under standard of care. Technologies are the methods being tested for this cancer, trials are the studies recorded here, and ideas are proposals not yet in a trial.
Primary refractory disease.
Also on OnCo: Resistance: how tumours escape each drug class · Lines of therapy.
CAR-T access and cost.
Also on OnCo: Financial help · Coverage by country · Funding verdicts by country.
Primary refractory disease (~10-15%) still has poor outcomes even with CAR-T; CD19-negative and CD20-negative escape after targeted therapy.
Also on OnCo: Resistance: how tumours escape each drug class · Lines of therapy.
No head-to-head comparison of bispecifics and CAR-T; sequencing is by access rather than evidence.
Also on OnCo: Financial help · Coverage by country · Funding verdicts by country.
Overall survival is hard to demonstrate for bispecifics against chemotherapy with crossover and effective later lines (EPCORE DLBCL-1).
Trial generalisability: STARGLO's rejection shows regional enrolment can decide approvals.
CNS relapse: prophylaxis with high-dose methotrexate is of uncertain benefit and CNS-penetrant options are few.
Background: Minimal / molecular residual disease (MRD). Also on OnCo: Treatment journeys · Survivorship planner.
Older and frail patients are underrepresented; R-mini-CHOP cure rates lag and cellular therapies carry toxicity.
Background: Quality of life. Also on OnCo: Side effects by symptom · Checkpoint side effects by organ · Side effect rates across a drug class · Survivorship planner.
Cost and access: CAR-T requires certified centres; bispecific CRS management needs infrastructure; lenalidomide-based triplets add expense.
Also on OnCo: Financial help · Coverage by country · Funding verdicts by country.
Response-adapted therapy: interim PET is unreliable and ctDNA is not yet a regulatory endpoint.
Polatuzumab vedotin prevents relapses in first-line diffuse large B-cell lymphoma without a proven survival gain: POLARIX gave five-year progression-free survival of 64.9 against 59.1 per cent but overall survival of 82.3 against 79.5 per cent, hazard ratio 0.85, not significant. Nobody can yet tell an individual patient whether the extra drug will add years or only delay a relapse that is salvaged anyway.
Background: Minimal / molecular residual disease (MRD). Also on OnCo: Treatment journeys · Survivorship planner.
Central nervous system prophylaxis has been given to tens of thousands of people for decades without a randomised trial, and the largest study of patients who received it found the relapse rate identical to the rate predicted without it. Whether any prophylaxis works, and for whom, is unanswered, and the trial that would answer it has never been run.
Background: Minimal / molecular residual disease (MRD). Also on OnCo: Treatment journeys · Survivorship planner.
No treatment for relapsed large B-cell lymphoma after CAR-T has shown a survival benefit in a randomised trial. Bispecific antibodies produce durable remissions in a minority, and which minority cannot be predicted before treatment.
Background: Minimal / molecular residual disease (MRD). Also on OnCo: Treatment journeys · Survivorship planner.
The trials that established CAR-T in second line disagreed with each other (ZUMA-7 and TRANSFORM positive, BELINDA negative) for reasons that are believed to be manufacturing time and permitted bridging rather than biology, which means a treatment's effect depends on a logistics chain that is not measured in the trial report.
Older and frail patients are systematically under-represented: POLARIX capped enrolment at 80 and required performance status 0 to 2, so the evidence for the commonest presentation of this lymphoma, a person in their late seventies or eighties, rests on single-arm and retrospective work.
Dated changes read from the records linked to this cancer: approvals, regulatory steps, reported trials, guideline versions and milestones. Newest first; no date is inferred.
On EdgeAll 84 changes by month →When this page itself was last checked or edited.
sBLA for frontline high-risk DLBCL (frontMIND) planned H1 2026
EPCORE DLBCL-1 topline: PFS met, OS (US primary endpoint) not met
R-CHOP × 6 (or Pola-R-CHP); consider 4 cycles plus 2 rituximab in young low-risk patients (FLYER). (NCCN Category 1)
Pola-R-CHP × 6 (POLARIX) or R-CHOP × 6; tafasitamab + lenalidomide + R-CHOP (frontMIND) pending approval for IPI 3-5; DA-EPOCH-R for double-hit lymphoma; CNS prophylaxis for high CNS-IPI (contested). (NCCN Pola-R-CHP category 1 for IPI 2-5)
CD19 CAR-T (axi-cel or liso-cel) preferred over salvage chemotherapy and transplant (ZUMA-7, TRANSFORM); bridging therapy while manufacturing; bispecific ± chemotherapy if CAR-T unavailable. (NCCN Category 1 (axi-cel, liso-cel))