Latest lymphoma research

One way we stay up-to-date with scientific research is by attending meetings which report the latest findings from studies and clinical trials. In April we attended the British Society of Haematology’s Annual Scientific Meeting in Liverpool, and in June we went to the Haematology Highlights for the UK Post Summer Congresses meeting in London.

We heard from the top experts in the field about optimising the use of currently available treatments, as well as promising new treatments in the pipeline. Both meetings showcased the passion and drive of the lymphoma research community to improve the lives of those affected by lymphoma.

Here we report on some of the main themes in current lymphoma research.

Individualised approach to treatment

With a growing range of treatment options available, studies are focussing on determining which treatment is best for each individual. Every lymphoma case is different, with varying factors, such as the lymphoma type, stage and specific genetic variations, as well as the individual’s age and fitness.

Each of these differences might impact the response to treatment. Predicting this response is key to offering the best treatment option, tailored for each individual.

Examples of the approaches being researched include:

• Using the level of a biomarker called ctDNA to understand the burden of disease. Studies have shown that this can help to predict the outcome of treatment for diffuse large B-cell lymphoma (DLBCL) and could therefore be used to identify whether an individual would benefit from additional treatment.
• Testing for specific mutations (genetic changes) to determine the treatment approach. Whilst this is already done to some extent for specific types of lymphoma, identifying combinations and patterns of mutations to determine molecular subtypes, could take this a step further. This could improve the accuracy of diagnosis and optimise the treatment choice.
• Assessment of the tumour ‘microenvironment’ using single cell analysis to give additional information to determine treatment choice.
• Using ‘measurable residual disease’ (MRD) to determine the optimal duration of treatment or to identify people who would benefit from additional treatment. This is being explored for many types of lymphoma, including follicular lymphoma and chronic lymphocytic leukaemia (CLL).

Reducing treatment burden

For many types of lymphoma, treatment is very successful. Choice of treatment must be based on the goals and preferences of the individual as each treatment option comes with potential side-effects. Clinical studies are exploring ways to reduce the burden of treatment whilst maintaining the positive outcomes.

Examples of the questions being explored include:

• Can the number of rounds of chemotherapy be reduced? For example, using four rather than six rounds of BrECADD for Hodgkin lymphoma may be sufficient for some people, reducing the impact of side-effects. Determining who would benefit from the additional rounds of treatment is key.
• What are the effects of treatment on fertility? Does treatment result in late effects (health problems that develop months or years after treatment)? Understanding the full impact can help guide treatment choice.

Optimal sequencing of treatments

With novel treatments such as CAR-T therapy and bispecific antibodies adding to the choices available, research is exploring the best time in the treatment pathway to use each option. In addition, it is important to understand if and how previous treatments might impact the potential success of future treatments.

Examples of options being explored include:

• Using CAR-T therapy earlier, for those with DLBCL who have not been previously treated.
• Using bispecific antibodies earlier in the treatment pathway as they are currently only available for treating relapsed or refractory DLBCL after two or more previous treatments.
• Combining treatments which might have complimentary modes of action to improve outcomes. Studies will need to demonstrate the safety and tolerability of the combinations.