Lenalidomide combined with R-CHOP (R2-CHOP) in the treatment of newly diagnosed double-expressor diffuse large B-cell lymphoma: a prospective phase II clinical trial

作者：Yizhen Liu, Qunling Zhang, Fangfang Lv, Xiaojian Liu, Dongmei Ji, Zuguang Xia, Jia Jin, Rong Tao, Wenhao Zhang, Xiaoqiu Li, Shengjian Zhang, Zezhou Wang, Jiachen Wang, Xiaonan Hong, Junning Cao · 发表于：Blood Cancer Journal · 年份：2025 · DOI：10.1038/s41408-025-01229-5 · 被引用次数：4 · 研究领域：Lymphoma Diagnosis and Treatment、CNS Lymphoma Diagnosis and Treatment、Chronic Lymphocytic Leukemia Research

Diffuse large B-cell lymphoma (DLBCL) stands as the predominant subtype of non-Hodgkin’s lymphoma (NHL) among adults, accounting for 30–40% of cases globally. Apart from its marked invasiveness, DLBCL demonstrates significant heterogeneity across various parameters, including cellular origin, morphological characteristics, immunohistochemical phenotype, cellular molecular genetics, sites of occurrence within and outside lymph nodes, response to chemotherapy, and survival rates [ 1 ]. Double expressor diffuse large B-cell lymphoma (DE-DLBCL) is a distinct subtype characterized by heightened expression of MYC (≥40%) and BCL-2 (the cut-off varied considerably in the literature, but a figure of ≥50% is recommended) as determined by immunohistochemistry (IHC) [ 2 ]. DE-DLBCL currently lacks standardized treatment regimens. Compared to non-double-expressor DLBCL, DE-DLBCL patients exhibit inferior outcomes when treated with standard immunochemotherapy [ 3 ]. Notably, a review of outcomes revealed markedly lower 5-year overall survival rates (OS) and progression-free survival rates (PFS) for DE-DLBCL, at 36% and 32%, respectively, in stark contrast to those observed for non-double-expressor DLBCL (71% and 65%) [ 4 ]. Furthermore, investigations indicated that the application of the R-CHOP regimen in DE-DLBCL treatment resulted in a 2-year PFS rate of approximately 54% [ 5 ]. While more intensive chemotherapy regimens such as DA-EPOCH-R, R-hyperCVAD alternating with MTX/cytarabine, a...