A Blog from the Lymphoma Program at Weill Cornell Medicine and NewYork-Presbyterian
Weill Cornell’s Dr. John Leonard will be on the panel of experts participating in Cancer Care’s telephone workshop “Update on Diffuse Large B-Cell Lymphoma” on Wednesday, October 5 from 1:30 to 2:30 pm, Eastern Time.
The workshop is free of charge. No phone charges apply. However, pre-registration is required to secure a place on the call. Click here for more information and to register for the workshop.
On September 23 New York Governor Andrew Cuomo signed into law a bill that requires health plans to cover orally administered chemotherapy treatments at a cost equal to intravenously or injected chemotherapy treatments. The bill will go into effect January 2012.
Traditional intravenous chemotherapy drugs administered in a hospital or clinic are often included as a medical benefit under a patient’s health insurance plan. However, many oral chemotherapies are defined as a prescription benefit and frequently require much higher out-of-pocket costs for patients, or they have been unavailable to patients with financial caps on their prescription benefit.
For lymphoma patients, oral chemotherapy agents that are sometimes used include cyclophosphamide (cytoxan), etoposide (VP-16), and procarbazine (matulane).
Regarding the new legislation, Dr. John Leonard, the Clinical Director of the Weill Cornell Lymphoma Program, said, “This is a very important law to allow our patients access to some of the crucial drugs that they need. A great deal of credit goes out to those who highlighted this issue for our legislators and asked them to take these steps. It speaks to the importance of having all of us take an active role in encouraging government policies that can improve outcomes for patients. “
By Peter Martin, MD and Olivier Elemento, PhD
Based on multiple randomized phase 3 studies initiated over a decade ago, R-CHOP chemotherapy is the standard of care for first-line treatment of patients with diffuse large B-cell lymphoma (DLBCL). However, sometimes R-CHOP is not successful. Fortunately, our understanding of lymphoma has evolved over the past decade.
It is increasingly clear that “DLBCL” is a heterogeneous group of related tumors. Studies using gene expression profiling [1], have revealed that DLBCL can be divided into three subgroups based on the probable cell of origin (i.e., the cell from which the lymphoma was derived): activated B-cell like DLBCL (ABC), germinal center-like DLBCL (GCB), and a third group, termed “type 3”, that doesn’t possess any specific characteristics (click here to read the abstract). So far, the clinical relevance of differentiating between the ABC and GCB subtypes of DLBCL remains somewhat unclear. Nonetheless, studies done at Weill Cornell Medical College and elsewhere have suggested that certain treatments might preferentially benefit one subtype (see here and here). As a result, ongoing clinical trials are evaluating newer therapies targeted to the appropriate subgroup.
Just as we are beginning to understand the significance of DLBCL gene expression profiles, recent technological advances in DNA sequencing are making the rapid, high-resolution sequencing of a tumor’s entire genome (DNA code) possible and affordable [2]. Two recently published papers describe the results of long-term efforts by two different groups to sequence the genome of DLBCL tumors.
In a paper entitled “Frequent mutation of histone-modifying genes in non-Hodgkin lymphoma” published in the journal Nature, Gascoyne, Marra and colleagues describe the results of a groundbreaking study. The researchers sequenced the entire DNA code from lymphoma tumors and compared the results to normal DNA obtained from the same patients. They were able to identify several genes that were mutated in the tumors but not in the normal DNA. Using these data, they were able to identify 109 genes with a potential role in lymphoma. Continue reading “Lymphoma in the News: Two Important Studies Take Us One Step Closer to Personalized Lymphoma Therapy”
New Developments in Lymphoma 