World Lymphoma Day: Confronting Challenges and Offering Hope through Breakthrough Innovation
Estimated 25,000 new cases of DLBCL are diagnosed annually
In India, nearly 30-40% of people diagnosed with DLBCL do not survive for five years, which is worse than the global average
40% of all DLBCL patients relapse and face disease progression even after initial treatment.
The first FDA-approved therapy for first-line treatment of DLBCL in almost 20 years is now available in India
New treatment regimen reduce chance of the disease getting worse, relapse, or causing death by 27% compared to current treatment option
77% of patients who got the new treatment had no worsening of their disease after 2 years
As the incidence of lymphoma – the most common type of blood cancer – continues to rise steadily in India, the need for advanced treatment options has become increasingly urgent. Diffuse Large B-Cell Lymphoma (DLBCL), the most aggressive form of non-Hodgkin lymphoma (NHL), alone accounts for around 25,000 new cases annually in the country. Despite existing treatments, nearly 40% of DLBCL patients face relapse or disease progression, creating significant challenges for patients, their families, and the healthcare system.
However, there is renewed hope as the first FDA-approved therapy for first-line treatment of DLBCL in almost 20 years is now available in India. This breakthrough marks a pivotal milestone in the fight against DLBCL, offering patients access to cutting-edge care and the potential for improved outcomes.
Challenges in Diagnosis & Treatment Pathway
While DLBCL is a highly treatable and potentially curable form of blood cancer, mortality remains concerning, particularly in patients with returning disease (relapse/refractory).
In India, nearly 30-40% of people diagnosed with DLBCL do not survive for five years, which is worse than the global average.
A significant issue in the treatment pathway is misdiagnosis and delayed referrals by general physicians, which often result in compromised treatment efficacy.
Limited progress has been made in improving patient outcomes in previously untreated DLBCL over the last two decades. While many patients are responsive to initial treatment, as many as four in ten people do not respond to initial treatment or relapse within two years after initial treatment. These patients face limited treatment options, which adds to the emotional and psychological toll on them and their families, who live in constant fear of the disease returning.
A Breakthrough After 20 Years
For the first time in nearly two decades, there has been a groundbreaking advancement in DLBCL treatment with a new drug: Polatuzumab in combination with chemotherapy. This is the first FDA-approved therapy in nearly 20 years for the first-line treatment of DLBCL, a hard-to-treat disease and the most common form of NHL. 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)
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.
Globally, over 23,000 patients have been treated in the first-line setting, and the drug is now approved in more than 90 countries, underscoring its worldwide impact.
Polatuzumab in combination with chemotherapy is now also a preferred regimen for first line treatment of DLBCL treatment under National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology.
Meeting Unmet Needs in DLBCL
The best chance of preventing relapse in people with DLBCL is with effective and tolerable therapy at the time they are first diagnosed and have received no prior treatment. When subsequent therapy is needed, the course of the disease tends to have worse outcomes.
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.
Clinical data shows a 27% reduction in the risk of progression, relapse or death in patients treated with Polatuzumab in the first line. Furthermore, 77% of patients treated with this therapy were progression-free for two years, providing a lifeline to those who previously had limited options.
Dr Sajjan Rajpurohit , Senior Director, BLK-Max Super Speciality Hospital said: “One of the key challenges in treating DLBCL is misdiagnosis and delayed referrals from general physicians, which can disrupt the patient’s treatment journey and compromise effectiveness. Since the symptoms of DLBCL can be non-specific, they are sometimes mistaken for more common infections like tuberculosis, leading to delays in proper diagnosis. Early and accurate diagnosis, followed by timely initiation of advanced treatment options like Polatuzumab can significantly improve outcomes, leading to complete remission and reduced mortality rates.
Dr Pawan Singh, Director-Hematology, Yatharth Super Speciality Hospital : “In cases of Diffuse Large B-Cell Lymphoma (DLBCL), 40% of patients relapse or progress after first line therapy. Hence there is need for newer and better therapies in the first line. to improve outcomes. By adopting innovative therapies like polatuzumab as the new standard of care (SoC) in first line treatment, we can increase their chances of cure, while also easing the financial and emotional burden that comes with relapse or disease progression. This shift would be crucial in improving both survival rates and quality of life for DLBCL patients in India.
Dr Sushant Mittal, Director Medical Oncology, Action Cancer Hospital: "First-line treatment for DLBCL presents the best opportunity for a successful outcome. Most relapses occur within the first 24 months of starting treatment, but patients who don't progress during this period have better survival rates. Hence It is crucial to offer the most effective treatment option in the first-line setting to reduce the risk of disease progression and increase the chances of a curative outcome."