Primary refractory plasmablastic lymphoma: A precision oncology approach.

Autor:	Witte HM; Department of Hematology and Oncology, University Hospital of Schleswig-Holstein, Lübeck, Germany.; Department of Hematology and Oncology, Federal Armed Forces Hospital, Ulm, Germany., Fähnrich A; Medical Systems Biology Group, Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany.; Institute for Cardiogenetics, University of Lübeck, Lübeck, Germany.; University Cancer Center Schleswig-Holstein, University Hospital of Schleswig- Holstein, Lübeck, Germany., Künstner A; Medical Systems Biology Group, Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany.; Institute for Cardiogenetics, University of Lübeck, Lübeck, Germany.; University Cancer Center Schleswig-Holstein, University Hospital of Schleswig- Holstein, Lübeck, Germany., Riedl J; Department of Hematology and Oncology, University Hospital of Schleswig-Holstein, Lübeck, Germany.; Hämatopathologie Lübeck, Reference Centre for Lymph Node Pathology and Hematopathology, Lübeck, Germany., Fliedner SMJ; Department of Hematology and Oncology, University Hospital of Schleswig-Holstein, Lübeck, Germany.; University Cancer Center Schleswig-Holstein, University Hospital of Schleswig- Holstein, Lübeck, Germany., Reimer N; Medical Systems Biology Group, Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany.; Institute for Cardiogenetics, University of Lübeck, Lübeck, Germany.; University Cancer Center Schleswig-Holstein, University Hospital of Schleswig- Holstein, Lübeck, Germany., Hertel N; Department of Hematology and Oncology, University Hospital of Schleswig-Holstein, Lübeck, Germany., von Bubnoff N; Department of Hematology and Oncology, University Hospital of Schleswig-Holstein, Lübeck, Germany.; University Cancer Center Schleswig-Holstein, University Hospital of Schleswig- Holstein, Lübeck, Germany., Bernard V; Hämatopathologie Lübeck, Reference Centre for Lymph Node Pathology and Hematopathology, Lübeck, Germany., Merz H; University Cancer Center Schleswig-Holstein, University Hospital of Schleswig- Holstein, Lübeck, Germany., Busch H; Medical Systems Biology Group, Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany.; Institute for Cardiogenetics, University of Lübeck, Lübeck, Germany.; University Cancer Center Schleswig-Holstein, University Hospital of Schleswig- Holstein, Lübeck, Germany., Feller A; Hämatopathologie Lübeck, Reference Centre for Lymph Node Pathology and Hematopathology, Lübeck, Germany., Gebauer N; Department of Hematology and Oncology, University Hospital of Schleswig-Holstein, Lübeck, Germany.; University Cancer Center Schleswig-Holstein, University Hospital of Schleswig- Holstein, Lübeck, Germany.
Jazyk:	angličtina
Zdroj:	Frontiers in oncology [Front Oncol] 2023 Feb 27; Vol. 13, pp. 1129405. Date of Electronic Publication: 2023 Feb 27 (Print Publication: 2023).
DOI:	10.3389/fonc.2023.1129405
Abstrakt:	Introduction: Hematologic malignancies are currently underrepresented in multidisciplinary molecular-tumor-boards (MTB). This study assesses the potential of precision-oncology in primary-refractory plasmablastic-lymphoma (prPBL), a highly lethal blood cancer. Methods: We evaluated clinicopathological and molecular-genetic data of 14 clinically annotated prPBL-patients from initial diagnosis. For this proof-of-concept study, we employed our certified institutional MTB-pipeline (University-Cancer-Center-Schleswig-Holstein, UCCSH) to annotate a comprehensive dataset within the scope of a virtual MTB-setting, ultimately recommending molecularly stratified therapies. Evidence-levels for MTB-recommendations were defined in accordance with the NCT/DKTK and ESCAT criteria. Results: Median age in the cohort was 76.5 years (range 56-91), 78.6% of patients were male, 50% were HIV-positive and clinical outcome was dismal. Comprehensive genomic/transcriptomic analysis revealed potential recommendations of a molecularly stratified treatment option with evidence-levels according to NCT/DKTK of at least m2B/ESCAT of at least IIIA were detected for all 14 prPBL-cases. In addition, immunohistochemical-assessment (CD19/CD30/CD38/CD79B) revealed targeted treatment-recommendations in all 14 cases. Genetic alterations were classified by treatment-baskets proposed by Horak et al. Hereby, we identified tyrosine-kinases (TK; n=4), PI3K-MTOR-AKT-pathway (PAM; n=3), cell-cycle-alterations (CC; n=2), RAF-MEK-ERK-cascade (RME; n=2), immune-evasion (IE; n=2), B-cell-targets (BCT; n=25) and others (OTH; n=4) for targeted treatment-recommendations. The minimum requirement for consideration of a drug within the scope of the study was FDA-fast-track development. Discussion: The presented proof-of-concept study demonstrates the clinical potential of precision-oncology, even in prPBL-patients. Due to the aggressive course of the disease, there is an urgent medical-need for personalized treatment approaches, and this population should be considered for MTB inclusion at the earliest time. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2023 Witte, Fähnrich, Künstner, Riedl, Fliedner, Reimer, Hertel, von Bubnoff, Bernard, Merz, Busch, Feller and Gebauer.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu