APLUSA-blog

DLBCL Market Overview

Written by AplusA | Jul 9, 2020 4:00:00 AM

Following the release of our latest ebook, this is the first blog post in this series focusing on Diffuse Large B Cell Lymphoma, the most common form of Non Hodgkin Lymphoma (NHL). The DLBCL market is experiencing considerable growth; it is predicted to reach a size of almost USD 4.3 billion by 2022.

The insights shared here, and in the eBook that you can download for free are taken from AplusA’s syndicated DLBCL market tracker. The research features insights from at least 100 US and 250 European hematologist / oncologists. 

DLBCL is an aggressive cancer of infection-fighting lymphocytes (white blood cells) characterized by rapid enlargement of lymph nodes. So-called “B-symptoms” include fever, night sweats, and unexplained weight loss. 

Although diffuse large B-cell lymphoma is the most common sub-type of non-Hodgkin lymphoma, it is easily classified as an orphan disease. Its annual incidence in western countries is roughly 3.8 per 10,000 inhabitants. For 2020, this ratio translates into approximately 1,250 new patients each in the EU5 and in the US. 

Left untreated, the disease can quickly lead to death. Fortunately, DLBCL is highly responsive to treatment, and a large percentage of patients never experience relapse. 

Reported DLBCL Market Chemotherapy Regimens 

Table 1: Reported DLBCL Chemotherapy Regimens

 

Regimen 

Definition 

ACVBP +/-R 

doxorubicin, cyclophosphamide, vindesine,  bleomycin,  prednisone, 

Benda +/-R 

bendamustine 

CHOP +/-R 

cyclophosphamide, doxorubicin (hydroxydaunorubicin), vincristine (Oncovin), and prednisone 

CHOP 14 +/-R  

(Same as CHOP but shortened treatment interval) 

DHAP +/-R 

dexamethasone, high-dose ara-c, cisplatin (platinol) 

EPOCH +/-R 

etoposide phosphate, prednisone, vincristine sulfate (Oncovin), cyclophosphamide, doxorubicin (hydroxydaunorubicin) 

ESHAP +/-R 

etoposide, solu-medrol, high-dose ara-c, cisplatin (platinol) 

GDP +/-R 

gemcitabine, dexamethasone, cisplatin (platinol) 

GEMOX +/-R 

gemcitabine, oxaliplatin 

ICE +/-R 

ifosfamide, carboplatin, etoposide 

mini CHOP +/-R 

(Same as CHOP but dose-adjusted down for elderly/frail patients) 

Pixa 

Pixantrone 

 

In addition to chemotherapy regimens, the European Medicine’s Agency (EMA) and the US Food and Drug Administration (FDA) have approved several branded drug therapies for the treatment of DLBLC. Table 2 lists these regimens in order of first regulatory approval. AplusA’s market tracker reports that so far, except for rituximab and bendamustine, usage of branded therapies within the DLBCL market is negligible

Branded Drugs Approved for the Treatment of DLBCL

 

Generic name 

Marketer / 

Brand 

Class of therapy 

Approval date 

 

General  R/R DLBCL usage 

rituximab 

EU: Roche’s MabThera 

US: Biogen/ Genentech’s Rituxan 

EU/US: Biosimilars 

CD20-directed cytolytic antibody 

June 1998 

Nov. 1997 

Combined with chemotherapy or as a single-agent for low-grade DLBCL 

ibritumomab tiuxetan 

Aurobindo’s Acrotech division’s Zevalin 

CD20-directed radiotherapeutic antibody 

Jan. 2004 

Feb. 2002 

EU: After rituximab 

US: R/R low-grade b-Cell non-Hodgkin’s lymphoma 

bendamustine 

EU: Mundipharma/ Astellas’ Levact/ Ribomustin/ Ribovact 

US: Eagle/ Teva’s Treanda/ Bendeka/ Belrapzo 

Bifunctional mechlorethamine derivative (chemotherapy) 

July 2010 

March 2008 

After rituximab 

pixantrone 

Servier/ CTI Biopharma’s Pixuvri 

Anthracycline (chemotherapy) 

May 2012 

N/A 

EU: As monotherapy for multiply relapsed or refractory aggressive disease 

US: Not approved 

tisagenlecleucel 

Novartis’ Kymiriah 

CD19-directed autologous CAR T-cell 

immunotherapy 

Aug. 2018 

Aug. 2017 

For specific DLBCL sub-types After two or more systemic therapies  

axicabtagene ciloleucel 

Gilead/ Kite’s Yescarta 

CD19-directed autologous CAR T-cell 

immunotherapy 

Aug. 2018 

Oct. 2017 

For specific DLBCL sub-types after two or more systemic therapies 

polatuzumab vedotin 

Roche/ Genentech’s Polivy 

CD79b-directed antibody-drug conjugate 

Jan. 2020 

June 2019 

Combined with bendamustine and rituximab 

EU: For patients not candidates for stem cell transplant 

US: After two or more prior therapies  

 

For further details on the fast-moving DLBCL market as well as treatment performance, patient journey insights from the patient chart tracker as well as from our social media intelligence study download the full eBook here: 

 

 

 

Sources:

AplusA DLBCL Syndicated Market Tracker 2020

https://www.technavio.com/report/global-diffuse-large-b-cell-lymphoma-dlbcl-therapeutics-market-analysis-share-2018?tnplus