Treatment of Primary Gastric Lymphoma (High-Grade DLBCL) After R-CHOP Failure to Achieve Complete Remission

Gastric diffuse large B-cell lymphoma (DLBCL) — the most common histological type of gastric lymphoma, also known as high-grade gastric lymphoma — requires a structured next-line approach when initial chemoimmunotherapy does not produce complete remission.

Clinical Scenario

This protocol addresses patients with gastric diffuse large B-cell lymphoma (high-grade gastric lymphoma) whose disease did not respond adequately to first-line anthracycline-based chemoimmunotherapy.

Previous Line — Failure Condition

First-line therapy: R-CHOP (anthracycline-based chemoimmunotherapy). The defined treatment goal — complete remission assessed by PET CT at the end of therapy — was not achieved, indicating persistent or progressive disease and triggering escalation to this next-line protocol.

Next-Line Approach (Partial Overview)

The approach at this stage centres on second-line salvage chemotherapy. For patients who respond, autologous stem cell transplantation may be considered as a subsequent step. The complete regimen options, selection criteria, and sequencing are detailed in the full protocol.

Instant Access to Structured Evidence-Based Regimens

References

The DLBCL represents the most common histological type of gastric lymphoma, sometimes called high-grade gastric lymphoma.

The treatment of DLBCL-PGL consists of anthracycline-based chemoimmunotherapy.

The PET CT should be done at the end of therapy, and if the patient has progressive disease, the consideration for second-line treatment (salvage chemotherapy) for DLBCL with a regimen, such as rituximab, ifosfamide, carboplatin, and etoposide or Gemcitabine, dexamethasone, and cisplatin and rituximab, followed by autologous stem cell transplantation should be considered.

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