Lymphoma

New treatments are taking aim at blood cancers that exploit the immune system.

Liquid biopsies, based on detecting DNA from tumour cells circulating in the blood, can guide clinicians to the most effective treatments.

A therapeutic approach in which a person’s immune cells are genetically recoded to enable them to target their cancerous cousins is helping people whose disease is beyond the reach of existing treatments.

Treatments for Hodgkin’s lymphoma can inflict a toll on the body that is felt for decades to come.

The dramatic success of ibrutinib has created a more hopeful reality for people with lymphoma, as targeted therapies fill the pipeline.

F. Hoffmann-La Roche Ltd (Roche) has a rich history of antibody therapies to treat cancers (malignancies) that affect B cells (a type of white blood cell), including non-Hodgkin lymphoma and chronic lymphocytic leukaemia. While dependent on the type of cancer and the stage when the cancer is diagnosed, the outcomes for patients with B-cell malignancies are generally poor and require further improvement.

The last resort for many people with lymphoma is to have a stem-cell transplant — a procedure that often leads to the body rejecting the therapy.

Studying lymphoma in canines yields insight into therapies for people — with a bonus of helping the animals.

Researchers are closing in on vaccines to prevent or treat lymphomas and other cancers triggered by the Epstein–Barr virus.

Numerous treatment options have emerged for lymphomas, but there are still considerable challenges to be tackled to increase the chances of long-term survival.

F. Hoffmann-La Roche Ltd ( Roche) was founded in Basel, Switzerland, in 1896. Since then, Roche has grown into one of the world's leading healthcare companies. With over 100 years of experience, we have driven progress and innovation in healthcare and pride ourselves as being pioneers in the development of new treatments for cancer.

Recent genomic and transcriptomic analyses of diffuse large B cell lymphoma (DLBCL) have provided important new insights into the heterogeneous biology of this disease. The findings provide opportunities to improve treatment strategies, although considerable work is needed to establish and optimize the clinical applicability and utility of molecular classifications of DLBCL.

Response criteria for disease assessment have important therapeutic and prognostic implications in clinical trials and in routine clinical practice. The Lugano classification has been used widely for evaluation of the response of patients with lymphoma to treatment, although the alternative Response Evaluation Criteria In Lymphoma 2017 (RECIL 2017) classification was recently proposed; these criteria are compared herein.

Cell-based immunotherapies are showing great promise in the treatment of even the most treatment-refractory of haematological malignancies. Herein, Jennifer Brudno and James Kochenderfer review the results obtained to date with CAR-T-cell therapies for lymphoma. They also discuss what has been learned regarding the limitations of CAR-T-cell therapies and areas for improvement relating to toxicity management, the design of CAR-T-cell products, conditioning regimens, and combination therapies.

The treatment landscape for lymphoma has become crowded, requiring efficient prioritization for expedited drug development. New challenges include the optimal duration of therapy, as well as the need to balance cost, benefit, and late-onset toxicity. Herein, the authors overview of the most-promising agents in clinical development for the treatment of lymphoma, and provide expert opinion on new strategies to streamline drug development as well as approaches for patient selection and for incorporating new end points into clinical trials.

This Review discusses the mutational landscape and evolution of follicular lymphoma. Deciphering the earliest initiating lesions and the molecular alterations leading to disease progression might help identify the most relevant targets for therapy of these tumours.

Pule and colleagues identify the TCR β-chain constant region as a new target for chimeric antigen receptor (CAR) T cells in treatment of T cell cancers while potentially preserving a healthy T cell repertoire. They demonstrate that anti-TCRB1 CAR T cells eliminate cancerous TCRB1⁺ T cells while sparing nearly one-third of normal TCRB2⁺ T cells.

Blocking IL-1 and iNOS prevents CAR T cell–induced cytokine release syndrome.

Comprehensive integration of mutational and structural alterations in clinically-annotated DLBCL patient samples provides a novel molecular classification of the disease.

Accurate detection and monitoring of treatment responses is an essential element of the management of patients with lymphoma. In this Perspectives, the authors describe the evolution of lymphoma staging criteria and highlight unaddressed questions, which, if answered, will substantially improve the management of patients with lymphoma.

Immune-checkpoint inhibitors are revolutionizing the treatment of many types of solid cancer. Expression of the inhibitory immune-checkpoint proteins programmed cell-death 1 (PD-1) and its ligands (PD-L1 and PD-L2) are frequently detected in haematological malignancies, and agents targeting these proteins have activity in such diseases, notably Hodgkin lymphoma. Herein, the current evidence supporting the roles of PD-1–PD-L1 blockade in the treatment of various B-cell malignancies is reviewed.

Several novel strategies have harnessed the ability of T cells to target cancer cells. Each treatment approach is based on unique platforms that should encourage development of further therapeutic agents in the future. The authors describe the background and development of distinct immunotherapy platforms, summarize the scientific advances in understanding the mechanism of action of each therapy, and discuss future strategies to improve these immunotherapies through enhanced engineering, biomarker selection, and mechanism-based combination regimens.

In leukemic mice, fasting reduces the development of acute lymphoblastic leukemia, but not acute myeloid leukemia, via upregulation of leptin receptor expression and signaling in the leukemic cells.