Promising personalized therapeutic options for diffuse large B-cell Lymphoma Subtypes with oncogene addictions

Clin Cancer Res. 2012 Sep 1;18(17):4538-48. doi: 10.1158/1078-0432.CCR-12-0217. Epub 2012 Jun 27.

Abstract

Currently, two major classification systems segregate diffuse large B-cell lymphoma (DLBCL) into subtypes based on gene expression profiles and provide great insights about the oncogenic mechanisms that may be crucial for lymphomagenesis as well as prognostic information regarding response to current therapies. However, these current classification systems primarily look at expression and not dependency and are thus limited to inductive or probabilistic reasoning when evaluating alternative therapeutic options. The development of a deductive classification system that identifies subtypes in which all patients with a given phenotype require the same oncogenic drivers, and would therefore have a similar response to a rational therapy targeting the essential drivers, would significantly advance the treatment of DLBCL. This review highlights the putative drivers identified as well as the work done to identify potentially dependent populations. These studies integrated genomic analysis and functional screens to provide a rationale for targeted therapies within defined populations. Personalizing treatments by identifying patients with oncogenic dependencies via genotyping and specifically targeting the responsible drivers may constitute a novel approach for the treatment of DLBCL.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Review

MeSH terms

  • Anaplastic Lymphoma Kinase
  • DNA-Binding Proteins* / genetics
  • DNA-Binding Proteins* / metabolism
  • Gene Expression Profiling
  • Gene Expression Regulation, Neoplastic
  • Genotype
  • Humans
  • Lymphoma, Large B-Cell, Diffuse* / diagnosis
  • Lymphoma, Large B-Cell, Diffuse* / genetics
  • Lymphoma, Large B-Cell, Diffuse* / metabolism
  • Lymphoma, Large B-Cell, Diffuse* / therapy
  • NF-kappa B* / genetics
  • NF-kappa B* / metabolism
  • Precision Medicine
  • Prognosis
  • Proto-Oncogene Proteins c-bcl-2* / genetics
  • Proto-Oncogene Proteins c-bcl-2* / metabolism
  • Proto-Oncogene Proteins c-bcl-6
  • Receptor Protein-Tyrosine Kinases* / genetics
  • Receptor Protein-Tyrosine Kinases* / metabolism

Substances

  • BCL6 protein, human
  • DNA-Binding Proteins
  • NF-kappa B
  • Proto-Oncogene Proteins c-bcl-2
  • Proto-Oncogene Proteins c-bcl-6
  • Anaplastic Lymphoma Kinase
  • Receptor Protein-Tyrosine Kinases