Front-line DLBCL Therapies in Canada in 2026: Biology Matters

Authors

  • Jia Li Liu, MD
  • Nathalie A. Johnson, MD, PhD, FRCPC

Abstract

Diffuse large B-cell lymphoma (DLBCL) is an aggressive lymphoma responsible for 30–40% of adult non-Hodgkin lymphoma cases. It can develop on its own or from indolent lymphoma.1-2 R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) has been the front-line standard therapy choice since 2002, but about 20% of patients do not achieve a complete response, and 20–30% experience relapse.3-4 While the International Prognostic Index (IPI) helps predict outcomes, certain biological features can signal a higher risk of treatment failure.5 Historically, adding targeted therapies to R-CHOP has not improved outcomes. Recently, two phase III trials, POLARIX (targeting CD79b) and FRONTMIND (targeting CD19), showed improved progression-free survival (PFS) over R-CHOP. This review summarizes current front-line DLBCL therapy, emphasizing how biology can guide treatment choices.

Author Biographies

Jia Li Liu, MD

Dr. Jia Li (Lily) Liu is a Hematology resident at McGill University. She completed her medical degree and Internal Medicine training at McGill University and is currently completing her Hematology training. Her research interests are in malignant hematology, with a focus on clinical outcomes and the evolving role of emerging therapies, including cellular therapy.

Nathalie A. Johnson, MD, PhD, FRCPC

Dr. Nathalie Johnson is the Director of the division of Hematology at McGill University and holds the Louis Lowenstein Chair in Hematology and Oncology. She is a hematologist at the Jewish General Hospital in Montreal who performs translational and clinical research since 2010. Her research focuses on studying mechanisms of therapeutic resistance to conventional and novel therapies and identifying early relapsed lymphoma using plasma circulating tumor DNA. She is the primary investigator of several clinical trials that test novel treatments for patients with newly diagnosed or relapsed lymphoma. She is also the program director for Clinical Investigator Program at McGill University.

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2026-09-24

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Front-line DLBCL Therapies in Canada in 2026: Biology Matters. Can Hematol Today [Internet]. 2026 Sep. 24 [cited 2026 Sep. 24];5(2):47-58. Available from: https://canadianhematologytoday.com/article/view/5-2-Liu_et_al

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1.
Front-line DLBCL Therapies in Canada in 2026: Biology Matters. Can Hematol Today [Internet]. 2026 Sep. 24 [cited 2026 Sep. 24];5(2):47-58. Available from: https://canadianhematologytoday.com/article/view/5-2-Liu_et_al