Pixantrone is a Safe and Effective Therapeutic Option for Elderly Patients with Relapsed Refractory Diffuse Large B-Cell Lymphoma in the Real-World Setting

Treatment of Relapsed/Refractory (R/R) Diffuse Large B-cell Lymphoma (DLBCL) remains an unmet need in every day clinical practice. Pixantrone is an approved by European Medicines Agency (EMA) for R/R DLBCL last generation anthracenedione developed to reduce the risk of cardiotoxicity. However real-world data regarding efficacy and safety of this agent are limited and controversial. In our study we analyzed 13 heavily pretreated elderly DLBCL patients who were treated with at least 1 cycle of pixantrone. The overall response rate was 46%; 3 patients achieved complete response and 3 patients had partial remission. All the responders were anthracycline sensitive as they had responded to anthracycline-based regimens upfront. Four responders had extranodal involvement (skin: 2, oropharynx: 1, oral cavity:1). Interestingly, 3 of the responders displayed long remission after first line therapy (87, 62 and 37 months, respectively). Regarding safety Pixantrone was well tolerated there was no treatment discontinuation due to Adverse Events. Our results indicate that Pixantrone is effective and safe in heavily pretreated DLBCL patients. Further studies are warranted to identify the subgroup of patients who may benefit from therapy with pixantrone and to identify the optimum positioning of the drug in the treatment of DLBCL.