Successful salvage therapy with glofitamab followed by selinexor maintenance in an elderly patient with primary refractory diffuse large b-cell lymphoma harboring TP53 and CD58 mutations: a case report and literature review
- 1Lanzhou University Second Hospital
- 2Lanzhou University
Abstract
Diffuse large B-cell lymphoma (DLBCL) is the most common aggressive B-cell lymphoma characterized by pronounced heterogeneity. Patients with relapsed/refractory (R/R) disease after standard R-CHOP regimen face an extremely poor prognosis with subsequent salvage lines. Although chimeric antigen receptor T-cell (CAR-T) therapy represents a breakthrough option for R/R DLBCL, its clinical utility is frequently constrained by various real-world factors in elderly patients. As an alternative T-cell-engaging modality, CD3×CD20 bispecific antibodies (BsAbs) have demonstrated robust efficacy in R/R DLBCL. Herein, we report a 70-year-old male with primary refractory DLBCL harboring co-existing TP53 and CD58 mutations. The patient was refractory to prior lines of therapy, including R-CDOP(rituximab, cyclophosphamide, liposomal doxorubicin, vincristine, and prednisone), R-GemOx(rituximab, gemcitabine, and oxaliplatin), a BTK inhibitor (zanubrutinib, 160 mg bid), and Pola-BR regimen (polatuzumab vedotin, bendamustine, and rituximab). Remarkably, he achieved a sustained CR following 12 cycles of glofitamab monotherapy and subsequent the XPO1 inhibitor selinexor maintenance, complicated solely by a manageable tumor flare reaction (TFR). This case suggests that glofitamab, potentially followed by targeted maintenance, offers a promising, highly effective, and manageable treatment strategy for elderly patients with ultra-high-risk, multi-line refractory DLBCL.
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BibTeX
@article{zhang2026successful,
title = {{Successful salvage therapy with glofitamab followed by selinexor maintenance in an elderly patient with primary refractory diffuse large b-cell lymphoma harboring TP53 and CD58 mutations: a case report and literature review}},
author = {Yurong Zhang and Huan Liu and Liangliang Li and Chune Wang and Jiajia Cao and Pengyun Zeng and Lingling Yue and Chongyang Wu},
journal = {Frontiers in Oncology},
year = {2026},
month = oct,
doi = {10.3389/fonc.2026.1908174},
url = {https://www.frontiersin.org/articles/10.3389/fonc.2026.1908174/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Successful salvage therapy with glofitamab followed by selinexor maintenance in an elderly patient with primary refractory diffuse large b-cell lymphoma harboring TP53 and CD58 mutations: a case report and literature review
AU - Yurong Zhang
AU - Huan Liu
AU - Liangliang Li
AU - Chune Wang
AU - Jiajia Cao
AU - Pengyun Zeng
AU - Lingling Yue
AU - Chongyang Wu
PY - 2026
DA - 2026/10/28
JO - Frontiers in Oncology
DO - 10.3389/fonc.2026.1908174
UR - https://www.frontiersin.org/articles/10.3389/fonc.2026.1908174/full
AB - Diffuse large B-cell lymphoma (DLBCL) is the most common aggressive B-cell lymphoma characterized by pronounced heterogeneity. Patients with relapsed/refractory (R/R) disease after standard R-CHOP regimen face an extremely poor prognosis with subsequent salvage lines. Although chimeric antigen receptor T-cell (CAR-T) therapy represents a breakthrough option for R/R DLBCL, its clinical utility is frequently constrained by various real-world factors in elderly patients. As an alternative T-cell-engaging modality, CD3×CD20 bispecific antibodies (BsAbs) have demonstrated robust efficacy in R/R DLBCL. Herein, we report a 70-year-old male with primary refractory DLBCL harboring co-existing TP53 and CD58 mutations. The patient was refractory to prior lines of therapy, including R-CDOP(rituximab, cyclophosphamide, liposomal doxorubicin, vincristine, and prednisone), R-GemOx(rituximab, gemcitabine, and oxaliplatin), a BTK inhibitor (zanubrutinib, 160 mg bid), and Pola-BR regimen (polatuzumab vedotin, bendamustine, and rituximab). Remarkably, he achieved a sustained CR following 12 cycles of glofitamab monotherapy and subsequent the XPO1 inhibitor selinexor maintenance, complicated solely by a manageable tumor flare reaction (TFR). This case suggests that glofitamab, potentially followed by targeted maintenance, offers a promising, highly effective, and manageable treatment strategy for elderly patients with ultra-high-risk, multi-line refractory DLBCL.
SN - 2234-943X
ER -