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Leo I. Gordon, MD, FACP


Zanubrutinib Plus Rituximab: Effective Alternative to R-CHOP in Elderly Patients With DLBCL?

By: Julia Fiederlein
Posted: Wednesday, August 24, 2022

The Bruton’s tyrosine kinase inhibitor zanubrutinib plus rituximab appeared to be a well-tolerated and effective regimen in treatment-naive elderly Chinese patients with diffuse large B-cell lymphoma (DLBCL) who are unfit to receive rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP), according to Hui Liu, MD, of Beijing Hospital, China, and colleagues. Their findings, which were presented during the European Hematology Association (EHA) 2022 Congress (Abstract PB2097), should prompt further studies in larger cohorts.

“The overall response rate of elderly unfit patients with DLBCL who received a reduced dose [of the] R-CHOP regimen was only 60%,” the investigators remarked. “It is extremely important to explore new therapeutic options.”

A total of eight elderly patients were treated with 160 mg of oral zanubrutinib twice daily plus 375 mg/m2 of intravenous rituximab on day 1 of every 28-day cycle for a total of eight courses. Maintenance therapy with 160 mg of oral zanubrutinib was administered twice daily until disease progression or unacceptable toxicity.

Two patients achieved a complete response, which was maintained at 8 months. Of the four patients who achieved a partial response, one experienced disease progression. One patient achieved stable disease after two cycles and experienced disease progression after four cycles, and one patient was refractory to treatment and withdrew from therapy after two cycles. As a result of disease progression, one patient died, with an overall survival of 11 months.

Grade 2 urinary tract infection, grade 2 respiratory infection, grade 1 petechial hemorrhage, grade 2 skin rash, and grade 2 deep vein thrombosis were reported in this population. No adverse events of grade 4 or higher were observed. A dose reduction was required in seven patients due to toxicity. Two patients discontinued treatment with zanubrutinib because of adverse events lasting between 1 and 3 weeks.

Disclosure: For full disclosures of the study authors, visit

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