Experience with acalabrutinib as a component of molecularly adapted antitumor therapy according to the R-CHOP-X protocol in patients with newly diagnosed diffuse large B-cell lymphoma

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Abstract

Background. Despite tremendous progress in understanding tumor biology, the R-CHOP protocol remains the standard of care for diffuse large B-cell lymphoma (DLBCL). To date, six genetic variants of DLBCL have been identified, the most unfavorable of which when using standard therapy are N1, MCD and BN2, which dictates the need to optimize the treatment of these DLBCL subtypes.
Aim. To evaluate the efficacy and toxicity of Acala-R-CHOP regimen in induction therapy in patients with newly diagnosed DLBCL.
Materials and methods. The study included 15 patients who received Acala-R-CHOP program as part of the first-line therapy. This antitumor regimen was used for verified genotypes N1, MCD and BN2. The median age was 64 (38–78) years. The incidence of genetic variants in the considered cohort of patients: MCD – 13 % (n = 2), N1 – 74 % (n = 11), BN2 – 13 % (n = 2).
Results. Fifteen patients completed the therapy. The overall and complete metabolic response rates were 100 %. Toxicity was moderate, quite manageable and manifested mainly as myelosuppression.
Conclusion. The efficacy of Acala-R-CHOP therapy in patients with MCD, N1, and BN2 DLBCL genotypes is high with a low toxicity profile. However, longer follow-up periods are needed to assess the long-term results in this unfavorable group of patients.

About the authors

M. A. Mingalimov

Moscow City Clinical Hospital No. 52, Moscow Healthcare Department; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

Author for correspondence.
Email: mingalimovm@yandex.ru
ORCID iD: 0000-0002-8491-2140

Marat Albertovich Mingalimov

Build. 3, 3 Pekhotnaya St., Moscow 123182

Build. 2, 8 Trubetskaya St., Moscow 119991

Russian Federation

E. A. Baryak

Moscow City Clinical Hospital No. 52, Moscow Healthcare Department; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University); Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia

ORCID iD: 0000-0001-6880-9269

Build. 3, 3 Pekhotnaya St., Moscow 123182

Build. 2, 8 Trubetskaya St., Moscow 119991

Build. 1, 2 / 1 Barrikadnaya St., Moscow 125993

Russian Federation

A. V. Misyurin

Vavilov Institute of General Genetics, Russian Academy of Sciences

ORCID iD: 0000-0003-1349-2879

3 Gubkina St., Moscow 119991

Russian Federation

L. A. Kesaeva

GeneTechnology

ORCID iD: 0000-0001-8277-8649

104 Profsoyuznaya St., Moscow 117437

Russian Federation

A. S. Mkrtchyan

GeneTechnology

ORCID iD: 0000-0002-0638-213X

104 Profsoyuznaya St., Moscow 117437

Russian Federation

E. N. Misyurina

Moscow City Clinical Hospital No. 52, Moscow Healthcare Department; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

ORCID iD: 0000-0003-2419-4850

Build. 3, 3 Pekhotnaya St., Moscow 123182

Build. 2, 8 Trubetskaya St., Moscow 119991

Russian Federation

M. A. Donskoy

Moscow International Oncology Center (European Medical Center)

ORCID iD: 0009-0007-1757-4683

Build. 4, 2 Durova St., Moscow 129090

Russian Federation

T. N. Tolstykh

Moscow City Clinical Hospital No. 52, Moscow Healthcare Department; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

ORCID iD: 0000-0001-7308-0927

Build. 3, 3 Pekhotnaya St., Moscow 123182

Build. 2, 8 Trubetskaya St., Moscow 119991

Russian Federation

M. S. Orlova

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

ORCID iD: 0009-0009-6369-5413

Build. 2, 8 Trubetskaya St., Moscow 119991

Russian Federation

T. S. Chudnova

Moscow City Clinical Hospital No. 52, Moscow Healthcare Department; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

ORCID iD: 0000-0002-8012-1640

Build. 3, 3 Pekhotnaya St., Moscow 123182

Build. 2, 8 Trubetskaya St., Moscow 119991

Russian Federation

D. D. Ivanova

Moscow City Clinical Hospital No. 52, Moscow Healthcare Department

ORCID iD: 0009-0004-3632-9198

Build. 3, 3 Pekhotnaya St., Moscow 123182

Russian Federation

O. L. Kochneva

Moscow City Clinical Hospital No. 52, Moscow Healthcare Department

ORCID iD: 0000-0003-1338-8203

Build. 3, 3 Pekhotnaya St., Moscow 123182

Russian Federation

E. N. Zotina

Moscow City Clinical Hospital No. 52, Moscow Healthcare Department; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

ORCID iD: 0000-0001-9692-2541

Build. 3, 3 Pekhotnaya St., Moscow 123182

Build. 2, 8 Trubetskaya St., Moscow 119991

Russian Federation

A. B. Makeshova

Moscow City Clinical Hospital No. 52, Moscow Healthcare Department; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

ORCID iD: 0000-0002-0414-2554

Build. 3, 3 Pekhotnaya St., Moscow 123182

Build. 2, 8 Trubetskaya St., Moscow 119991

Russian Federation

S. S. Andreev

Moscow City Clinical Hospital No. 52, Moscow Healthcare Department

ORCID iD: 0000-0002-9147-4636

Build. 3, 3 Pekhotnaya St., Moscow 123182

Russian Federation

K. V. Yatskov

Moscow City Clinical Hospital No. 52, Moscow Healthcare Department

ORCID iD: 0000-0003-0125-9068

Build. 3, 3 Pekhotnaya St., Moscow 123182

Russian Federation

I. V. Samsonova

Moscow City Clinical Hospital No. 52, Moscow Healthcare Department

ORCID iD: 0000-0002-1228-1765

Build. 3, 3 Pekhotnaya St., Moscow 123182

Russian Federation

M. A. Lysenko

Moscow City Clinical Hospital No. 52, Moscow Healthcare Department

ORCID iD: 0000-0001-6010-7975

Build. 3, 3 Pekhotnaya St., Moscow 123182

Russian Federation

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