Article Text

Download PDFPDF

Aggressive B-cell lymphoma: chasing the target
Free
  1. Jan Walewski
  1. Lymphoid Malignancy, Maria Sklodowska-Curie Institute - Oncology Center, Warszawa, Poland
  1. Correspondence to Professor Jan Walewski, Lymphoid Malignancy, Maria Sklodowska-Curie Institute of Oncology Warsaw, Warszawa 02-034, Poland; jan.walewski{at}coi.pl

Abstract

One of the first achievements of molecular biology in lymphoma science was a discovery of cell of origin (COO) classification around 20 years ago with defining activated B-cell like (ABC) and germinal center B-cell like subtypes of diffuse large B-cell lymphoma (DLBCL) with the use of gene expression profiling. These categories were considered important as seemed to present different biology, response to treatment, and prognosis. Immunochemotherapy R-CHOP21 has been a standard of care for 2 decades, and it results in long-term disease-free survival or cure of 60% of patients with DLBCL but efficacy in an individual patient depends on age and other International Prognostic Index clinical risk factors and is within a range of 30% to more than 90%. Clinical attempts to enhance activity of immunochemotherapy in high-risk DLBCL like ABC or others included adding targeted agents to the R-CHOP backbone: bortezomib, lenalidomide, ibrutinib. Unfortunately, randomized clinical trials did not confirm the expected benefit. Recently, advanced molecular techniques were used to classify B-cell lymphomas beyond COO or MYC alterations and correlated with clinical outcome as illustrated by 2 recently published influential studies from the National Institutes of Health and from Dana Farber Cancer Center, USA. Advanced molecular pathogenesis descriptions of DLBCL provide a framework for actionable classifications that should be used for designing future clinical trials and hopefully bring success to treatment of high-risk aggressive lymphoma.

  • drugs
  • investigational
  • pharmacogenetics
View Full Text

Statistics from Altmetric.com

Footnotes

  • Contributors JW conceived, wrote, and edited the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests JW: Advisory role: Roche, Celgene, Takeda, Janssen-Cilag, Servier, Amgen, BMS, AbbVie, Novartis, Gilead. Research funding: Roche, GSK/Novartis, Takeda, Janssen-Cilag. Lecture honoraria: Roche, Celgene, Takeda, Janssen-Cilag, Servier, Amgen, AbbVie, Gilead. Conference travel support: Roche.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Linked Articles