A new tool for treating an aggressive form of blood cancer has been developed by British scientists.
It identifies those with the most lethal types of lymphoma who are less likely to respond to standard drugs.
Lymphomas arise when immune cells called lymphocytes become cancerous. There are two types: B-cells and T-cells.
They look the same under the microscope but the revolutionary technique found one in ten patients are half as likely to be cured with existing treatments.
Known as gene expression profiling it finds twice as many as previous methods.
Senior author Professor David Westhead, a biological scientist at Leeds University, said: “We have discovered which patients will be left at greater risk by only receiving standard treatment, and at nearly 10% of patients sufferers, it is a significant group.”
Diffuse large B-cell lymphoma affects almost 5,000 people in the UK every year – and is the most common form of the disease.
An analysis of the DNA of tumour cells from almost 1,000 patients discovered a group for whom they were much less effective.
It used complex computer models to examine 20,000 genes which make up the complete structure of human cells.
People with the ‘high grade’ tumours have a three-year survival rate after standard treatment of only about 37% – compared to 72% for all other cases.
Senior author Professor Ming-Qing Du, a pathologist at Cambridge University, said: “By identifying the molecular high grade group we have found the number of people who have a high chance of their lymphoma responding poorly to existing treatment is double what we expected.
“This should be a spur for pathologists to urgently re-assess the way we make the diagnosis so appropriate therapy can be tailored to the individual.”
The study published, in the Journal of Clinical Oncology, is part of a programme funded by the blood cancer charity Bloodwise.
This is a collaboration between a number of UK universities that is identifying more effective lymphoma drugs for people who do not respond to current treatments.
Senior author Prof Peter Johnson, an oncologist at Southampton University, said: “At the moment the standard treatment for this type of lymphoma is to use the R-CHOP combination of drugs.”
This includes antibodies andf chemotherapy but for patients with high grade lymphoma this may not be the best approach.
Prof Johnson said: “We need to make sure we identify them early on so we can consider different forms of treatment.
“At the moment we can use more intensive chemotherapy but by understanding the biology better we hope we can test more selective treatments with targeted agents.”
Dr Alasdair Rankin, director of Bloodwise, added: “This important research is tackling the challenge of accurately identifying lymphoma patients who will and won’t respond well to standard drugs.
“The next step will be to develop this approach for use in the NHS, so that more lives can be saved.”
By Ben Gelblum and Mark Waghorn
