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Primary mediastinal (thymic) large B-cell lymphoma: lines of therapy

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3 standard-of-care settings across 3 lines and 2 biomarker subgroups. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.

LineAll comersFRα
Advanced, first line1·
Third line and beyond·1
Other settings1·

Advanced, first line

SubgroupSettingApproachProducts and trialsEvidence
All comersFirst lineDose-adjusted EPOCH-R for six cycles without radiotherapy, or R-CHOP for six cycles with PET-guided consolidation radiotherapy; end-of-treatment PET decides whether radiotherapy is needed (IELSG37).88

Third line and beyond

SubgroupSettingApproachProducts and trialsEvidence
FRαRelapsed or refractorySalvage chemotherapy then autologous stem cell transplant if chemosensitive; pembrolizumab (KEYNOTE-170) or nivolumab plus brentuximab vedotin; CD19 CAR-T (axicabtagene ciloleucel, lisocabtagene maraleucel) after two lines or as second line for early relapse.98

Other settings

SubgroupSettingApproachProducts and trialsEvidence
All comersResidual PET-positive disease after immunochemotherapyBiopsy where feasible; involved-site radiotherapy to the mediastinum (30 to 36 Gy) for persistent uptake; salvage therapy for proven refractory disease.93

Regimens in the library

Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.