2 Clarke Drive
Cranbury, NJ 08512
© 2022 MJH Life Sciences™ and OncLive - Clinical Oncology News, Cancer Expert Insights. All rights reserved.
Research has shown that DLBCL is heterogeneous, suggesting that patients with varying subtypes should receive different courses of treatment.
Kieron Dunleavy, MD
Even though diffuse large B-cell lymphoma (DLBCL) is often viewed as a single type of non-Hodgkin lymphoma, research has shown that the disease is actually heterogeneous, suggesting that patients with varying subtypes should receive different courses of treatment.
Kieron Dunleavy, MD, a staff clinician with the National Cancer Institute, presented the available research on these DLBCL subtypes at the 16th Annual International Congress on Hematologic Malignancies.
Dunleavy said that there are 3 key subtypes: germinal center B-cell like DLBCL (GCB), activated B-cell DLBCL (ABC), and primary mediastinal B-cell lymphoma (PMBL).
Knowing these subtypes can help researchers determine appropriate targets for both distinguishing among subtypes and treating the disease. For example, the B-cell lymphoma 6 (BCL6) protein is associated with follicular lymphoma, but research has shown a close association between the protein and GCB.
“BCL6 almost always appears in GCB DLBCL,” Dunleavy said.
Another protein, c-MYC, is closely associated with GCB. Dunleavy said that patients with lymphoma treated with R-CHOP (rituximab [Rituxan], cyclophosphamide, hydroxydaunorubicin, vincristine, and prednisone) had a much worse prognosis if they were c-MYC—positive.
Based on early clinical trials, there is at least 1 therapeutic agent that appears to have had positive results on the ABC subtype. In a study (View Abstract) presented at the 2011 American Society of Hematology Annual Meeting, the Bruton’s tyrosine kinase inhibitor PCI-32765 was tested in 8 patients with relapsed or refractory ABC DLBCL. The results showed that 2 patients achieved complete response for 11+ and 5 months, respectively; 3 patients achieved stable disease for 4, 2, and 2 months, respectively; and 3 patients had progressive disease. The drug was generally well tolerated across the patient population.
“We've seen a wide range of activity with this drug,” Dunleavy said. “It’s certainly a promising agent.”