Novel immunotherapeutic strategies for diffuse large B-cell lymphoma: a comprehensive review

Diffuse large B-cell lymphoma (DLBCL) represents the most prevalent histological subtype of non-Hodgkin lymphoma, characterized by pronounced clinical and biological heterogeneity. Despite the incorporation of rituximab into the cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) regimen-achieving durable remission in approximately 60% of patients-30%-40% ultimately experience relapse or develop refractory disease, resulting in unfavorable clinical outcomes. Over the past decade, the advent of novel immunotherapeutic approaches has reshaped the therapeutic paradigm for relapsed/refractory (R/R) DLBCL. Emerging modalities, including monoclonal antibodies, immune checkpoint inhibitors, chimeric antigen receptor T-cell (CAR-T) therapies, antibody-drug conjugates, and bispecific antibodies, have demonstrated encouraging efficacy across multiple clinical settings. Nevertheless, the intrinsic complexity of resistance mechanisms, coupled with the substantial cost and limited accessibility of advanced molecular diagnostics, continues to hinder optimal disease management. This review summarizes the commonly used therapeutic strategies for DLBCL, discusses recent advances, and aims to provide insights for the future development of personalized treatment approaches.