Dr. Nowakowski on the Rationale of the ENGINE Trial in DLBCL

Grzegorz S. Nowakowski, MD, associate professor of medicine and oncology, as well as a consultant in the Division of Hematology, Department of Internal Medicine with Mayo Clinic, discusses the rationale for the ongoing, randomized phase 3 ENGINE study in diffuse large B-cell lymphoma (DLBCL).

In the ENGINE study, investigators are comparing the standard regimen of rituximab (Rituxan) plus cyclophosphamide, doxorubicin hydrochloride, vincristine sulfate, and prednisone (R-CHOP) versus R-CHOP in combination with enzastaurin (DB102) in patients with newly diagnosed DLBCL, says Nowakowski.

Results from the study suggest that the addition of a novel agent can improve the benefit of R-CHOP. The trial specifically focuses on patients with high-risk disease; only those who have a Lymphoma International Prognostic Index Score of 3 or more were permitted on the study.

In previous research, patients with a DGM-1 biomarker experienced a significant benefit with the addition of enzastaurin; this provided the rationale for ENGINE, says Nowakowski. In this patient population, the addition of the targeted agent resulted in an improvement in overall survival, concludes Nowakowski.