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This combination regimen consists of the Bruton's tyrosine kinase (BTK) inhibitor ibrutinib added to the standard R-CHOEP chemotherapy backbone, which includes rituximab, cyclophosphamide, doxorubicin, vincristine, etoposide, and prednisone. Investigated by the University Hospital Muenster, this regimen is specifically designed for younger, high-risk patients with diffuse large B-cell lymphoma (DLBCL). Ibrutinib works by irreversibly binding to BTK, thereby inhibiting B-cell receptor signaling pathways that drive malignant B-cell proliferation. The R-CHOEP component provides a multi-modal cytotoxic attack: rituximab targets CD20-positive B-cells for immune-mediated destruction, while the chemotherapy agents induce DNA damage and disrupt microtubule assembly to trigger apoptosis.
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