Aggressive B-Cell Lymphoma: Chasing the Target
| Autor: | Jan Walewski |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Oncology medicine.medical_specialty Lymphoma B-Cell Aggressive lymphoma General Biochemistry Genetics and Molecular Biology 03 medical and health sciences chemistry.chemical_compound Drug Delivery Systems 0302 clinical medicine International Prognostic Index hemic and lymphatic diseases Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans B-cell lymphoma Cyclophosphamide Randomized Controlled Trials as Topic Lenalidomide business.industry Bortezomib General Medicine medicine.disease Lymphoma Clinical trial 030104 developmental biology chemistry Doxorubicin Vincristine 030220 oncology & carcinogenesis Ibrutinib Mutation Disease Progression Prednisone Rituximab business medicine.drug |
| Zdroj: | Journal of Investigative Medicine. 68:331-334 |
| ISSN: | 1708-8267 1081-5589 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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