Tag: diffuse large B-cell lymphoma

Lymphoma in the News: Two Important Studies Take Us One Step Closer to Personalized Lymphoma Therapy

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.

A Groundbreaking Study

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”

Upcoming Cancer Care Workshop: Update on Diffuse Large B-cell Lymphoma

Cancer Care will present a Connect Education Workshop titled, “Update on Diffuse Large B-cell Lymphoma” via telephone on Wednesday, October 5, 2011 from 1:30 to 2:30 pm, Eastern Time. Weill Cornell’s Dr. John Leonard will be on the panel of experts.

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.

Weill Cornell Research: Epigenetic Priming to Improve Chemotherapy Response Can Be Safely Administered in AML Patients

By Rebecca Elstrom, MD

Researchers at Weill Cornell Medical Center have demonstrated that epigenetic priming of standard induction chemotherapy can be safely administered in an attempt to improve the response rate of patients with acute myeloid leukemia (AML).

Epigenetics refers to reversible alterations to DNA or DNA-associated proteins which affect gene expression, and epigenetic processes have been shown by researchers at WCMC and others to be disrupted in many types of cancer.  Drugs currently available and approved by the FDA can target these abnormal epigenetic changes, and pretreatment with these drugs (epigenetic priming) might make cancer cells more vulnerable to chemotherapy.

In the research study recently published in Blood, the Journal of the of the American Society of Hematology, patients were treated with the drug decitabine prior to a standard induction of chemotherapy. The toxicity, or side effects, of chemotherapy plus decitabine was similar to that of chemotherapy alone. Although the primary purpose of the study was to evaluate the safety of adding decitabine, the epigenetic primer, to standard chemotherapy, the overall complete response rate was 83%, suggesting that decitabine-primed induction should be explored as a complementary approach to standard chemotherapy. Click here to read the published research paper.

There is the possibility that the approach of epigenetic priming could translate into therapeutic advantages in other forms of cancers.  Many types of cancers have been shown to develop with abnormal epigenetic changes, including lymphoma.  The lymphoma research group at Weill Cornell Medical Center is  also exploring the strategy of epigenetic priming in patients with newly diagnosed aggressive B cell  non-Hodgkin’s lymphoma, in hopes of improving on results of standard chemotherapy. Click here to read more about this study. Click here to read the clinical and research profile of Rebecca Elstrom, MD, the physician leading the lymphoma trial.