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To investigate the efficacy and safety of zanubrutinib capsules-rituximab injection-lenalidomide capsules(ZR2) in the treatment of relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL).
Patients with R/R DLBCL were divided into control group and treatment group according to a random number table. The control group received rituximab injection 375 mg·m-2 by intravenous infusion on day 1 of the treatment cycle, and orally took lenalidomide capsules 25 mg once daily from day 1 to day 14 of the cycle. The treatment group received oral zanubrutinib capsule 160 mg twice daily from day 1 to day 21 of the cycle, in addition to the treatment given to the control group. Both groups were treated in 21-day cycles for a total of 6 cycles. The clinical efficacy, immune environment-related indicators, inflammation-related indicators, angiogenesis and metabolism-related indicators, rogression-free survival (PFS) and overall survival (OS) were compared between the two groups.
In control group, 2 cases were lost to follow-up and 1 case withdrew, resulting in 40 cases actually included; in treatment group, 3 cases were lost to follow-up, resulting in 40 cases actually included. After treatment, the disease control rates (DCR) of the control group and the treatment group were 60.00% and 82.50%, respectively; cluster of differentiation 3 positive T lymphocyte (CD3+) were (62.17±8.23)% and (67.29±7.95)%, respectively; cluster of differentiation 4 positive T lymphocyte (CD4+)/cluster of differentiation 8 positive T lymphocyte (CD8+) were 1.44±0.36 and 1.65±0.47, respectively; T helper 17 cell (Th17) were (1.37±0.34)% and (1.62±0.46)%, respectively; natural killer cell (NK) were (22.47±3.69)% and (24.86±4.12)%, respectively; tumor necrosis factor-alpha (TNF-α) were (23.35±6.28) and (19.62±5.31) pg·mL-1, respectively; soluble interleukin-2 receptor (sIL-2r) were (621.74±134.89) and (539.48±116.83) U·mL-1, respectively; lactate dehydrogenase (LDH) were (278.64±56.84) and (251.37±48.43) U·L-1, respectively; beta-2-microglobulin (β2-MG) were (1.86±0.87) and (1.49±0.74) mg·L-1, respectively; the PFS rates were 22.50% and 52.50%, respectively; the OS rates were 45.00% and 67.50%, respectively. The differences in the above data between the two groups of patients were statistically significant (all P<0.05). The total incidence of adverse drug reactions in the control group and the experimental group were 67.50% (27 cases/40 cases) and 77.50% (31 cases/40 cases) respectively, with no statistically significant difference, (P>0.05).
ZR2 regimen can improve the tumor immune microenvironment, suppress inflammatory responses and tumor angiogenesis in patients with R/R DLBCL, thereby leadingto higher DCR and improved long-term survival benefits, without increasing the risk of treatment-related adverse events.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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