How would you approach therapy for a patient with newly diagnosed non-GC DLBCL with previous anthracycline exposure?

For fit patients with prior anthracycline exposure for non-lymphoma healthcare who are fit for chemotherapy and with preserved LV function, I would recommend considering daR-EPOCH. The history of the regimen was its original development as treatment of relapsed lymphoma after 1L bolus doxorubicin, and we have recently reported its safety in patients with prior anthracycline exposure in the modern era (Buege et al., PMID 36971022). Checking intermittent echoes during treatment is an appropriate c...

In a young individual, I would be very reluctant to give an anthracycline, given previous exposure. It is preferred to use a chemotherapy combination that the patient has not been treated with previously, which may be associated with higher response rates. If transplant-eligible, a salvage regimen such as GDP, ICE, ESHAP with rituximab are associated response rates of 50-80% with CR rates of 25-50%.