R-CHOP resistance in diffuse large B-cell lymphoma: biological and molecular mechanisms / 中华医学杂志(英文版)
Chinese Medical Journal
;
(24): 253-260, 2020.
Article
in English
| WPRIM
| ID: wpr-877995
ABSTRACT
Although the first-line rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone regimen (R-CHOP) substantially improved outcomes for patients with diffuse large B-cell lymphoma (DLBCL), 40% of the patients suffered from relapsed/refractory disease and had poor survival outcomes. The detailed mechanism underlying R-CHOP resistance has not been well defined. For this review, we conducted a thorough search for literature and clinical trials involving DLBCL resistance. We discussed DLBCL biology, epigenetics, and aberrant signaling of the B-cell receptor (BCR), phosphatidylinositol 3-kinase (PI3K)/Akt, nuclear factor kappa light chain enhancer of activated B-cells (NF-κB), and the Janus kinase (JAK)/signal transducer and activator of transcription 3 (STAT3) pathways as defining mechanisms of DLBCL heterogeneity and R-CHOP resistance. The cell of origin, double- or triple-hit lymphoma and double-protein-expression, clonal evolution, tumor microenvironment, and multi-drug resistance help to contextualize DLBCL resistance in an (epi)genetically and biologically comparative manner. With better understanding of the biological and molecular landscape of DLBCL, a more detailed classification system and tailored treatments will ideally become available to further improve the prognosis of DLBCL patients.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Prognosis
/
Vincristine
/
Prednisone
/
Antineoplastic Combined Chemotherapy Protocols
/
Doxorubicin
/
Lymphoma, Large B-Cell, Diffuse
/
Phosphatidylinositol 3-Kinases
/
Cyclophosphamide
/
Tumor Microenvironment
/
Rituximab
Type of study:
Prognostic study
Limits:
Humans
Language:
English
Journal:
Chinese Medical Journal
Year:
2020
Type:
Article
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