Comprehensive assessment of DeVIC therapy for relapsed or refractory diffuse large B-cell lymphoma
Yosuke Nakaya1,2, Takuro Yoshimura3, Tetsuya Hayashi3
1Department of Hematology, Osaka City General Hospital, Osaka, Japan. ynakaya@omu.ac.jp.
International Journal of Hematology
|November 19, 2025
Summary
DeVIC (dexamethasone, etoposide, ifosfamide, and carboplatin) shows limited efficacy for relapsed or refractory diffuse large B-cell lymphoma (r/r DLBCL). Poor outcomes were linked to prior treatment resistance and high lactate dehydrogenase (LDH) levels.
Area of Science:
- Hematology
- Oncology
- Clinical Trials
Background:
- Relapsed or refractory diffuse large B-cell lymphoma (r/r DLBCL) presents a significant unmet need.
- Limited evidence exists on the efficacy and safety of DeVIC (dexamethasone, etoposide, ifosfamide, and carboplatin) chemotherapy in this patient population.
Purpose of the Study:
- To evaluate the efficacy and safety of DeVIC therapy in patients with r/r DLBCL.
- To identify predictors of response and survival in patients treated with DeVIC.
Main Methods:
- Retrospective analysis of 78 patients with r/r DLBCL treated with DeVIC therapy at a single institution.
- Assessment of overall response rate (ORR), complete response (CR), partial response (PR), and survival outcomes (overall survival [OS], progression-free survival [PFS]).
- Multivariable analyses and decision tree models were used to identify prognostic factors.
Main Results:
- The ORR was 37.2% (21.8% CR, 15.4% PR).
- Three-year OS and PFS were 28.2% and 18.0%, respectively.
- Refractoriness to prior therapy, elevated lactate dehydrogenase (LDH) levels, and central nervous system involvement were associated with poor outcomes.
- Hematological toxicities, including febrile neutropenia (52.6%), were frequent, with a 3.8% infection-related mortality rate.
Conclusions:
- DeVIC therapy demonstrates limited efficacy in r/r DLBCL, with significant toxicities.
- Prior treatment refractoriness and high LDH levels are negative prognostic indicators.
- Further research into novel therapeutic strategies and optimized bridging to transplantation or cellular therapy is warranted for selected patients.
