Glofitamab plus selinexor maintenance yields sustained CR in refractory DLBCL caseNew treatment strategy shows promise for hard to treat lymphoma
Frontiers in MedicinePublished October 30, 2026Study authors: Yurong Zhang, Huan Liu, Liangliang Li, Chune Wang, Jiajia Cao, Pengyun Zeng, Lingling Yue, Chongyang…DOI ↗Editorial oversight: Dr. Ji-eun Park, MD · Brain, Mind & Pain
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Key Takeaway
Recognize this as a single case report; glofitamab plus selinexor maintenance is not established standard.
This publication is a case report accompanied by a literature review, focused on a single patient with primary refractory diffuse large B-cell lymphoma (DLBCL) carrying TP53 and CD58 mutations. The patient was a 70-year-old male with a history of multiple prior lines of therapy, including rituximab, cyclophosphamide, liposomal doxorubicin, vincristine, prednisone, gemcitabine, oxaliplatin, zanubrutinib, polatuzumab vedotin, and bendamustine.
The reported intervention was glofitamab monotherapy followed by selinexor maintenance. The main result was a sustained complete response after 12 cycles of glofitamab. A tumor flare reaction was observed and described as manageable; serious adverse events and discontinuations were not reported. Follow-up duration was not reported.
The authors acknowledge that this is a single case report and that it does not establish a general clinical standard. No comparator was used, and no effect size, p-value, or confidence interval was provided. The report suggests that glofitamab followed by targeted maintenance may be a promising strategy for elderly patients with ultra-high-risk, multi-line refractory DLBCL, but this remains hypothesis-generating.
Practice relevance is limited by the case-report design. Clinicians should interpret the outcome as anecdotal and not as evidence to change standard management for refractory DLBCL.
How this fits prior evidence
This case report extends prior coverage of selinexor as an oral selective inhibitor of nuclear export in relapsed or refractory multiple myeloma by describing its use as maintenance after glofitamab in a single patient with refractory DLBCL. It also aligns with the prior note that miR-155 overexpression is frequently associated with treatment resistance across cancer types, given the patient's multi-line refractory disease, though the case does not report miR-155 status. The findings are anecdotal and do not confirm or contrast with the prior preclinical and clinical observations in a systematic way.
When a patient has a rare and aggressive form of lymphoma that does not respond to standard treatments, doctors often run out of options. This is especially true for older patients with specific genetic mutations that make the cancer harder to fight. This case study looks at a 70-year-old man with a high-risk form of lymphoma that had already failed multiple rounds of treatment.
Doctors treated him with a drug called glofitamab followed by a maintenance treatment called selinexor. The patient achieved a sustained complete response after 12 cycles of the first drug. While he did experience a tumor flare reaction, the side effects were manageable.
Because this is a single case report, we cannot say this is a new standard for everyone. However, it shows that this specific combination might be a promising path for elderly patients facing very difficult cases of lymphoma. Talk to your doctor to see if these specific treatments are right for your situation.
What this means for you:
A combination of glofitamab and selinexor showed success for a patient with a very hard to treat lymphoma.
Common questions
Who is this treatment for?
This specific treatment approach was used for a 70-year-old man with primary refractory diffuse large B-cell lymphoma. This type of lymphoma is very hard to treat because it did not respond to previous therapies and involved specific genetic mutations.
What are the side effects of this treatment?
The patient experienced a tumor flare reaction during treatment. However, the doctors reported that the side effects were manageable for the patient during the course of the therapy.
Is this a standard treatment for all lymphoma patients?
No, this was a single case report. Because it only involved one patient, it does not establish a general clinical standard for everyone. You should speak with your doctor to discuss the best options for your specific diagnosis.
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.
