Radiation + Antibody Therapy for Diffuse Large B-Cell Lymphoma

(REBEL Trial)

This trial tests a new treatment for diffuse large B-cell lymphoma, a type of blood cancer that has returned or resisted previous treatments. It combines a short course of external beam radiation therapy with a bispecific antibody treatment, which targets cancer cells. The trial aims to determine if this combination is safe and tolerable for patients. It may suit those who have tried at least two other treatments for this specific lymphoma and qualify for radiation therapy. As a Phase 1 trial, the research focuses on understanding how the treatment works in people, offering participants the opportunity to be among the first to receive this new therapy.

The trial does not specify if you need to stop taking your current medications, but you cannot be on any other approved or investigational therapy for lymphoma, except for corticosteroids. It's best to discuss your specific medications with the trial team.

Previous studies have shown that both epcoritamab and glofitamab are generally safe for patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL). Research indicates these treatments effectively manage side effects, though some patients experienced cytokine release syndrome and fatigue. Epcoritamab has been used safely in outpatient settings, enhancing accessibility and potentially improving patients' quality of life. Glofitamab also maintains a manageable safety profile, even for patients with extensive treatment histories. This information suggests both treatments are well-tolerated, but patients should remain aware of possible side effects.¹²³⁴⁵

Researchers are excited about the combination of radiation and bispecific antibody therapy for treating Diffuse Large B-Cell Lymphoma (DLBCL) because it introduces a novel approach to tackling this condition. Unlike traditional chemotherapy and monoclonal antibody treatments, this therapy uses bispecific antibodies like Epcoritamab or Glofitamab that can simultaneously bind to two different targets, potentially boosting the immune system's ability to attack cancer cells directly. Additionally, the integration of external beam radiation therapy over just five days may enhance the effectiveness of the antibody treatment by priming the cancer cells, making them more susceptible to immune attack. This approach could offer a new and potentially more effective treatment option for patients with DLBCL.

This trial will investigate the safety and tolerability of radiation therapy followed by bispecific antibody therapy with either Epcoritamab or Glofitamab for diffuse large B-cell lymphoma (DLBCL). Research has shown that both Epcoritamab and Glofitamab are promising treatments for relapsed or refractory DLBCL. Specifically, studies reported a 51% response rate to Epcoritamab, with 23% of patients achieving complete remission. Glofitamab showed a 53% response rate, with 30% achieving complete remission. Epcoritamab also reduced the risk of disease progression or death by 26% compared to chemotherapy. Additionally, Glofitamab improved outcomes, with a 27% complete remission rate in some real-world cases. These findings suggest that these treatments may effectively manage DLBCL symptoms for many patients.⁶⁷⁸⁹¹⁰