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Zilovertamab vedotin + rituximab + cyclophosphamide + doxorubicin + prednisone is an investigational combination regimen for diffuse large B-cell lymphoma (DLBCL). Zilovertamab vedotin is an antibody-drug conjugate (ADC) that targets receptor tyrosine kinase-like orphan receptor 1 (ROR1) and delivers the cytotoxic payload MMAE (monomethyl auristatin E), inducing cell death in ROR1-expressing cells. Rituximab is an anti-CD20 monoclonal antibody that mediates B-cell lysis by immune mechanism. Cyclophosphamide and doxorubicin are cytotoxic chemotherapeutics with DNA-alkylating and topoisomerase II-inhibiting activities, respectively. Prednisone is a synthetic glucocorticoid with immunosuppressive and anti-inflammatory effects. In combination, these agents offer synergistic antitumor activity by targeting lymphoma cells through distinct yet complementary mechanisms. The regimen is under clinical evaluation as a frontline therapy in untreated DLBCL, notably in the phase 2 waveLINE-007 trial and phase 3 waveLINE-011 trial. Results show high objective and complete response rates, especially at the established recommended phase 2 dose of zilovertamab vedotin (1.75 mg/kg)[2][5].
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