Lymphoma 2016: Targeted therapies, immunotherapy and better outcomes

December 29, 2015 | by By Letisia Marquez

2016 will bring an array of advances – both big and small – to the fight against lymphoma.
Whether through clinical trials of targeted therapies that attack specific molecules, or through combining treatment approaches such as bone marrow transplant and immunotherapy, City of Hope researchers are determined to speed scientific breakthroughs into practical benefits for patients.
Here, City of Hope experts Larry W. Kwak, M.D., Ph.D., director of the Toni Stephenson Lymphoma Center, and associate director for developmental therapeutics and translational research for the institution’s comprehensive cancer center, and Robert W. Chen, M.D., assistant professor in the Department of Hematology & Hematopoietic Cell Transplantation, answer five questions about lymphoma treatment and research advances expected in 2016.
1) What treatment advances do you expect for lymphoma in 2016?
Both experts say that, for Hodgkin lymphoma, several drugs – some currently in the clinical trial phase – are proving to be highly effective. 
Brentuximab vedotin, approved by the Food and Drug Administration (FDA) a few years ago as a targeted therapy for relapsed/refractory Hodgkin lymphoma, is one of those. Researchers are exploring its potential in a variety of clinical trials.  
“The drug has limited side effects, which is also an important consideration that researchers take into account when testing new therapies,” Kwak said. 
For non-Hodgkin lymphoma, new drugs such as ibrutinib are showing great promise. Ibrutinib is what’s known as a BTK inhibitor, and the FDA has already approved it for treatment of relapsed/refractory mantel cell lymphoma. Research so far suggests the drug is effective both alone and in combination with other drugs for specific subtypes of B cell lymphoma. 
At the same time, the patient’s own immune system is emerging as a potent ally in the fight against lymphoma. Several new drugs work to enhance the immune system so that it better fights cancer, and CAR T cell therapy takes that bolstering a step further. It re-engineers a patient’s immune T cells to recognize lymphoma cells through tumor-specific antigens.
Some drugs work against both Hodgkin and non-Hodgkin lymphoma: PD-1 and PD-L1 inhibitors enhance the patient’s own immune system with limited toxicity to the body, and PI3K inhibitors block an enzyme that cancer cells need to grow. Both are in clinical trials.
Drugs aren’t the only option, however. City of Hope researchers are also working to maximize the potential of other treatments. For instance, Leslie Popplewell, an associate clinical professor of hematology and hematopoietic cell transplantation, is using bone marrow transplant and immunotherapy against recurrent non-Hodgkin lymphoma. 
She presented some findings on the treatment at the recent American Society of Hematology’s annual conference. The patients first received a bone marrow transplant and then, two days later, an infusion of their own genetically modified T cells, a type of immune cell. The treatment proved safe overall, and many patients participating in the trial are still being monitored for treatment efficacy.
2) How significant are those advances for the overall field?
“With so many different types of drugs being tested, as well as immunotherapy research, it’s a very exciting time for the lymphoma field,” Chen said. “We understand the molecular biology behind lymphoma – and the subtypes of lymphoma – much better today, which is helping us develop new therapies in the field.”
3) How will this improve the patient experience or patient outcomes?
Because researchers can identify specific markers associated with the various subtypes of lymphoma, and specific targets to use to kill cancer cells, they are able to make new drugs that truly target cancer cells, the researchers said. In general, lymphoma treatment is very well-tolerated and highly effective.
4) What research progress do you expect in 2016?
“Researchers working on targeted therapies and immunotherapy will continue to make strides in 2016,” Kwak said.
5) Overall, where is the field of cancer treatment and research moving in lymphoma?
There are many different types of lymphoma and the prognosis and treatment is very different depending on the subtypes.
“Because we have so many new drugs that focus on specific target, it’s imperative that the right diagnosis is made,” Chen said. “Patients should seek a second opinion at a comprehensive cancer center designated by the National Cancer Institute, such as City of Hope, that has lymphoma experts which will correctly identify specific lymphoma subtypes and chose the best treatment.”

If you are looking for a second opinion or consultation about your treatment, request an appointment online or contact us at 800-826-HOPE. Please visit Making Your First Appointment for more information.

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