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
M. A. Mingalimov,
E. A. Baryak,
A. V. Misyurin,
L. A. Kesaeva,
A. S. Mkrtchyan,
E. N. Misyurina,
M. A. Donskoy,
T. N. Tolstykh,
M. S. Orlova,
T. S. Chudnova,
D. D. Ivanova,
O. L. Kochneva,
E. N. Zotina,
A. B. Makeshova,
S. S. Andreev,
K. V. Yatskov,
I. V. Samsonova,
M. A. Lysenko https://doi.org/10.17650/1818-8346-2025-20-3-22-26
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.
Supporting agencies: The study was conducted with financial support under grant No. 1803-10/23 “Personalization of DLBCL treatment based on mutational profile as a new strategy to improve the effectiveness of first-line therapy”.
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)
Russian Federation
Russian Federation
Marat Albertovich Mingalimov
Build. 3, 3 Pekhotnaya St., Moscow 123182
Build. 2, 8 Trubetskaya St., Moscow 119991
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
Russian Federation
Russian Federation
Build. 3, 3 Pekhotnaya St., Moscow 123182
Build. 2, 8 Trubetskaya St., Moscow 119991
Build. 1, 2 / 1 Barrikadnaya St., Moscow 125993
A. V. Misyurin
Vavilov Institute of General Genetics, Russian Academy of Sciences
Russian Federation
Russian Federation
3 Gubkina St., Moscow 119991
L. A. Kesaeva
GeneTechnology
Russian Federation
Russian Federation
104 Profsoyuznaya St., Moscow 117437
A. S. Mkrtchyan
GeneTechnology
Russian Federation
Russian Federation
104 Profsoyuznaya St., Moscow 117437
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)
Russian Federation
Russian Federation
Build. 3, 3 Pekhotnaya St., Moscow 123182
Build. 2, 8 Trubetskaya St., Moscow 119991
M. A. Donskoy
Moscow International Oncology Center (European Medical Center)
Russian Federation
Russian Federation
Build. 4, 2 Durova St., Moscow 129090
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)
Russian Federation
Russian Federation
Build. 3, 3 Pekhotnaya St., Moscow 123182
Build. 2, 8 Trubetskaya St., Moscow 119991
M. S. Orlova
I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Russian Federation
Russian Federation
Build. 2, 8 Trubetskaya St., Moscow 119991
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)
Russian Federation
Russian Federation
Build. 3, 3 Pekhotnaya St., Moscow 123182
Build. 2, 8 Trubetskaya St., Moscow 119991
D. D. Ivanova
Moscow City Clinical Hospital No. 52, Moscow Healthcare Department
Russian Federation
Russian Federation
Build. 3, 3 Pekhotnaya St., Moscow 123182
O. L. Kochneva
Moscow City Clinical Hospital No. 52, Moscow Healthcare Department
Russian Federation
Russian Federation
Build. 3, 3 Pekhotnaya St., Moscow 123182
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)
Russian Federation
Russian Federation
Build. 3, 3 Pekhotnaya St., Moscow 123182
Build. 2, 8 Trubetskaya St., Moscow 119991
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)
Russian Federation
Russian Federation
Build. 3, 3 Pekhotnaya St., Moscow 123182
Build. 2, 8 Trubetskaya St., Moscow 119991
S. S. Andreev
Moscow City Clinical Hospital No. 52, Moscow Healthcare Department
Russian Federation
Russian Federation
Build. 3, 3 Pekhotnaya St., Moscow 123182
K. V. Yatskov
Moscow City Clinical Hospital No. 52, Moscow Healthcare Department
Russian Federation
Russian Federation
Build. 3, 3 Pekhotnaya St., Moscow 123182
I. V. Samsonova
Moscow City Clinical Hospital No. 52, Moscow Healthcare Department
Russian Federation
Russian Federation
Build. 3, 3 Pekhotnaya St., Moscow 123182
M. A. Lysenko
Moscow City Clinical Hospital No. 52, Moscow Healthcare Department
Russian Federation
Russian Federation
Build. 3, 3 Pekhotnaya St., Moscow 123182
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Review
For citations:
Mingalimov M.A., Baryak E.A., Misyurin A.V., Kesaeva L.A., Mkrtchyan A.S., Misyurina E.N., Donskoy M.A., Tolstykh T.N., Orlova M.S., Chudnova T.S., Ivanova D.D., Kochneva O.L., Zotina E.N., Makeshova A.B., Andreev S.S., Yatskov K.V., Samsonova I.V., Lysenko M.A. 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. Oncohematology. 2025;20(3):22-26. (In Russ.) https://doi.org/10.17650/1818-8346-2025-20-3-22-26
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