Expert Pathologic Review Demonstrates Notable Significance in Lymphoma Care

A new study published by the Journal of Clinical Oncology proposes that pathologic review has direct implications on lymphoma diagnosis and management.

Over a four-year span, the Lymphopath Network, a national hematopathology expert network in France that reviews lymphoma cases prior to therapeutic decision, reviewed over 30,000 samples from patients with newly diagnosed or suspected lymphoma. Researchers found that a change in diagnosis from original referral to expert review occurred in almost 20 percent of patients, and the change was significant enough to potentially impact care in over 17 percent of patients.

Diagnostic discrepancies were greater in patient samples sent with a provisional diagnosis than in those sent with a formal diagnosis, meaning that when referring pathologists were confident about the diagnosis, they were typically correct. Although most discrepancies were due to misclassifications of lymphoma subtypes, some patients were referred with benign conditions that were deemed lymphomas after pathologic review.

The study implies that frequently, in order for patients to receive optimal care, their diagnoses are best determined in collaboration with expert pathologists – especially in the current age of personalized medicine.

Picture1
Dr. Peter Martin

“As doctors who take care of people with cancer, so much of what we do is dependent on having a precise diagnosis,” said Peter Martin, Chief of the Lymphoma Program at Weill Cornell Medicine and NewYork-Presbyterian. “My bias is to meet people early on so that I can help direct the diagnostic evaluation, minimize unnecessary testing, and work with our experts in radiology, surgery, and pathology to arrive at the correct diagnosis as rapidly as possible. Importantly, the findings from the Lymphopath Network study highlight that even when a diagnosis has already been made, a second opinion regarding pathology can be important, particularly when there is any diagnostic uncertainty.”

As part of our mission to deliver precise, individualized care to as many patients as possible, expert hematologists and oncologists at the Weill Cornell Medicine and NewYork-Presbyterian Lymphoma Program collaborate with our team of world-class hematopathologists to provide collective assessment of all individual cases, working our hardest to secure an accurate diagnosis before proceeding with the appropriate therapy.

Weill Cornell Researcher: A Personalized Approach for Targeting Cancer Tumors

Through a collaboration between researchers at Weill Cornell Medical College, Memorial Sloan-Kettering, and the National Cancer Institute, researchers have reported that a tumor-targeting compound called PU-H71 can reveal with great accuracy the set of altered pathways that contribute to malignancy, thus allowing physicians to “fish-out” entire networks of abnormal proteins in tumor cells.

One major obstacle in the fight against cancer is that anticancer drugs often affect normal cells in addition to tumor cells, resulting in significant side effects. Yet research into development of less harmful treatments geared toward the targeting of specific cancer-causing mechanisms is hampered by lack of knowledge of the molecular pathways that drive cancers in individual patients.

“A major goal of cancer research is to replace chemotherapy with drugs that correct specific molecular pathways disrupted by cancer,” said Weill Cornell’s  Dr. Ari Melnick, one of the study’s lead investigator. The research was published in Nature Chemical Biology.

The researchers have uncovered that PU-H71 can reveal, with great accuracy, the set of altered pathways contributing to malignancy, thus allowing physicians to “fish-out” entire networks of abnormal proteins in tumor cells. PU-H71 binds to these abnormal protein complexes which are part of protein networks supporting cancer cell growth, division and survival. This knowledge could lead to more targeted, effective and individualized therapies for the personalized treatment of cancer – a disease in which no two tumors are alike – while producing fewer side effects and ultimately sparing patients from undergoing chemotherapy.

Based on these findings Dr. Melnick and colleagues have received a multi-investigator collaborative grant from the National Cancer Institute in support of clinical trials for the treatment of cancer. Currently, patients are being recruited for the first clinical trial to test the safety of PU-H71 as a drug used for the treatment of a variety of tumors. Subsequent trials will include patients with cancers such as breast, lymphomas, and chemotherapy-resistant leukemia.