[Future directions in clinical development of first-line therapy for diffuse large B-cell lymphoma]

For an extended period, R-CHOP therapy was the standard of care for the first-line treatment of diffuse large B-cell lymphoma (DLBCL); nevertheless, approximately 30% of patients experience treatment resistance or relapse, highlighting the limitations of a "one-size-fits-all" treatment strategy. In recent years, however, the development of risk-adapted therapy based on molecular subtype identification and response-adapted therapy using circulating tumor DNA (ctDNA) to detect minimal residual disease has advanced considerably, building on Pola-R-CHP therapy, which became the new standard of care following the POLARIX trial. To further improve the cure rate of DLBCL, it is essential to integrate these molecular pathologies, the tumor microenvironment, and early treatment response assessment to establish personalized first-line treatment strategies that combine novel molecularly targeted drugs and immunotherapy.