ArticleBlood neoplasia2026
Low lymphoma macrophage infiltration predicts poor outcomes for R-CHOP- but not Pola-R-CHP-treated patients with DLBCL.
Article in Blood neoplasia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Not yet cited in PubMed.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Multicenter, Randomized, Double-blind, Placebo-controlled Phase III Trial Comparing the Efficacy of Bevacizumab in Combination With Rituximab and CHOP (R-CHOP + Bevacizumab) Versus Rituximab and CHOP (R-CHOP) in Previously Untreated Patients With CD20-positive Diffuse Large B-cell Lymphoma (DLBCL)
A Phase III, Multicenter, Open-Label Randomized Trial Comparing the Efficacy of GA101 (RO5072759) in Combination With CHOP (G-CHOP) Versus Rituximab and CHOP (R-CHOP) in Previously Untreated Patients With CD20-Positive Diffuse Large B-Cell Lymphoma (DLBCL)
A Phase III, Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial Comparing the Efficacy and Safety of Polatuzumab Vedotin in Combination With Rituximab and CHP (R-CHP) Versus Rituximab and CHOP (R-CHOP) in Previously Untreated Patients With Diffuse Large B-Cell Lymphoma
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Authors and funding
22 authors.
Funding
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Abstract
The influence of the tumor immune microenvironment (TME) on therapeutic efficacy remains unclear in diffuse large B-cell lymphoma, particularly for regimens incorporating antibody-drug conjugates (ADCs). We aimed to define the key lymphoma microenvironment factors associated with clinical outcomes in patients treated with anti-CD20 (rituximab or obinutuzumab) plus CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone; anti-CD20 + CHOP) and to understand how treatment with a modified, ADC-containing chemoimmunotherapy regimen alters the influence of the pretreatment immune landscape on clinical outcome. We evaluated associations between TME composition and clinical outcomes in a harmonized data set of 1279 patients treated with either anti-CD20 + CHOP or a modified regimen of anti-CD20 + CHOP containing polatuzumab vedotin (Pola-R-CHP) across 3 clinical studies. We found that low enrichment of M1-like macrophages was consistently associated with inferior overall and progression-free survival in anti-CD20 + CHOP-treated patients, suggesting that these macrophages may facilitate antibody-mediated efficacy. In contrast, outcomes in polatuzumab vedotin-treated patients were independent of macrophage levels, supporting a mechanism of action driven primarily by ADC payload cytotoxicity. Other immune signatures that predicted outcome with anti-CD20 + CHOP treatment were also not prognostic with Pola-R-CHP treatment. Our results indicate that ADCs may provide therapeutic benefit to patients with unfavorable immune microenvironments. These trials were registered at www.clinicaltrials.gov as #NCT01287741, #NCT00486759, and #NCT03274492.
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Registered trials
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