Towards better treatment outcomes in lymphoma by personalising medicine

Non-Hodgkin LymphomaNew directions in treatment for lymphoma are increasingly based on ‘personalised medicine’, which means identifying the best treatment for an individual patient.

The Leukaemia Foundation’s Head of Blood Cancer Support, Anthony Steele, said the overall aim of this approach was to optimise treatment outcomes.

“Currently, we do not have enough information about all of the subtypes of lymphoma, how these genetic differences impact on the disease, and what treatments are most effective at treating each subtype,” said Mr Steele.

“We are in the very early years of understanding this, but research has begun to focus on this in earnest.

“At the moment, it is common for similar treatments to be provided to large subgroups of people with lymphoma, but clinicians now realise that a specific therapy can more effectively target biologic differences in individuals’ blood cancers.”

Lymphoma affects an estimated 5500 Australians each year and the incidence of this sixth most common type of cancer is increasing. Peter Younis, a vet based in south-west Victoria, is on a clinical trial for the targeted therapy BGB-3111. Read his story here >

“There are more than 60 different subtypes of lymphoma and many treatment options are available for this most commonly diagnosed form of blood cancer,” Mr Steele said.

“Knowing more about the different subtypes enables the most effective treatment to be selected for each patient,” Mr Steele said.

“Not only are there unique biologic differences among the different subtypes of lymphomas but also between individuals with the same subtype! In the future, treatment decisions will not only be made on the genetic subtype, but also on how that subtype is behaving in an individual.

“We are not yet at the point of making most treatment decisions in lymphoma based on a patient’s genetic profile, and gene expression profiling isn’t routine care for all patients, because in many cases we do not yet know what to do with all that information.

“As more is learned about the biology of the different lymphomas and as more selective treatments are developed, tools to measure genetic differences will need to become routinely available,” said Mr Steele.

Lymphoma – Personalising Medicine is the Leukaemia Foundation’s theme for World Lymphoma Awareness Day (WLAD) – September 15.

The focus of education and support activities that will be held across Australia as part of WLAD includes:

  • genetic profiling of lymphomas;
  • targeted therapies; and
  • CAR T-cell therapy.

Mr Steele said being smarter in choosing the best drug for an individual patient means providing the optimal treatment, with the highest chance of helping the patient and sparing them the unnecessary toxicity of a drug that is not likely to work.

“As well, newer, more targeted therapies are likely to be expensive, so it is imperative that they are given to patients who will benefit.

“While chemotherapy has a broad mechanism of action, mostdrugs in development today are ‘targeted therapies’ with a known specific mode of action that is efficacious for certain cancers.

“The design of most drugs in development is based on genetic differences and abnormalities and clinical trials have biologic questions built into them to test whether patients have those biologic features,” he said.

For more information on personalised medicine and lymphoma click here.