A Review of Results from Clinical Trials Based on Co-Variants of the R-CHOP Regimen in Untreated Patients with Diffuse Large B-cell Lymphoma

Since 2000, new drugs for treating lymphoproliferative diseases have been introduced in haematology, and their initial indications have been gradually expanded. Some of the so-called „target molecules“ have shown good efficacy when treating some malignant non-Hodgkin lymphomas. The possibility of achieving therapeutic disease control in some indolent non-Hodgkin lymphomas using drugs with a different mechanism of action from that of cytostatics has logically raised the question of a change in therapeutic management in other lymphoproliferative diseases. Since 2010, clinical trials have been initiated with untreated patients with aggressive non-Hodgkin‘s lymphoma - diffuse large B-cell lymphoma as the primary target. The key aim of most clinical trials has been to compare the efficacy of the so-called „gold standard“ - rituximab, cyclophosphamide, doxorubicin, oncovin, prednisolone (R- CHOP) versus its derivatives. The review discusses the results of completed clinical trials published on the Internet. These trials covered covariants of the R-CHOP regimen used as first-line treatment of patients with diffuse large B-cell lymphoma. The review also includes drugs registered in Bulgaria for the last ten years but with a different clinical indication at present. The results of five clinical trials in which obinotuzumab, venetoclax, lenalidomide, bortezomib, and ibrutinib were used are presented.