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Molecular Subtyping in Diffuse Large B Cell Lymphoma: Closer to an Approach of Precision Therapy

  • Lymphoma (JW Sweetenham, Section Editor)
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Opinion Statement

It has become clear that there is immense biological heterogeneity in diffuse large B cell lymphoma (DLBCL). Developing technology has allowed better characterization of patient subsets at a molecular level, allowing for a link of phenotype and clinical outcomes to oncogenic mechanisms and biologic signatures. Cell of origin and double hit status are able to identify aggressive subsets, with molecular profiling allowing for a clearer understanding of biologic pathways that contribute to cellular resistance to conventional treatment in these subsets. Although the standard treatment for DLBCL remains R-CHOP or R-CHOP-like therapy at present, rational drug targets have been established with novel classes of drugs under investigation. In germinal center (GC) DLBCL, mechanisms of therapeutic interest include anti-apoptosis mediated by BCL-2, PI3K/AKT/mTOR, and EZH2, whereas drug interventions are directed at BCR, NF-κB, and/or JAK-STAT pathways in activated B cell (ABC) DLBCL. There is also evidence for cooperation of various oncogenic pathways in these subsets. As such, we are arguably on the verge of shifting to a more tailored approach using single and combinatorial strategies—this, however, relies on prioritizing the exploration of biomarkers for patient selection for validating novel treatment strategies.

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Authors and Affiliations

  1. Northwestern University Feinberg School of Medicine, 645 N Michigan Ave, Suite 1020, Chicago, IL, 60611-2927, USA

    Reem Karmali MD, MS

  2. Robert H. Lurie Comprehensive Cancer Center, Chicago, IL, 60611, USA

    Reem Karmali MD, MS & Leo I. Gordon MD, FACP

  3. Northwestern University Feinberg School of Medicine, 676 North St. Clair Street, Suite 850, Chicago, IL, 60611-2927, USA

    Leo I. Gordon MD, FACP

Authors
  1. Reem Karmali MD, MS
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  2. Leo I. Gordon MD, FACP
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Correspondence to Reem Karmali MD, MS.

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Conflict of Interest

Reem Karmali has received compensation from Celgene for serving on speakers’ bureaus and from Pharmacyclics and Seattle Genetics for service as a consultant.

Leo I. Gordon declares that he has no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Lymphoma

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Karmali, R., Gordon, L.I. Molecular Subtyping in Diffuse Large B Cell Lymphoma: Closer to an Approach of Precision Therapy. Curr. Treat. Options in Oncol. 18, 11 (2017). https://doi.org/10.1007/s11864-017-0449-1

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  • DOI: https://doi.org/10.1007/s11864-017-0449-1

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