Dr. Pagel on the Shift Toward Precision Medicine in Large Cell Lymphoma

John M. Pagel, MD, PhD, chief of the Hematologic Malignancies Program, and director, Hematopoietic Cell Transplantation Program, at Swedish Cancer Institute, discusses the shift toward precision medicine in large cell lymphoma.

The field has learned that not all large cell lymphomas are the same, says Pagel. Biologically, they’re very different. Now, it is known that there are different cells of origin and there are different genetic signatures, a handful of which confer different outcomes to treatment. Work is ongoing to define the optimal therapy for these patients, says Pagel.

Through this enhanced understanding of disease biology, researchers have developed more personalized treatment strategies. For example, the combination of lenalidomide (Revlimid) and rituximab (Rituxan; R²), which has demonstrated activity in patients with activated B-cell type or non-germinal center diffuse large B-cell lymphoma, is now associated with long-term benefit in patients with specific genetic signatures. Additionally, data have shown that R² is relatively well tolerated, especially in older and frailer patients who are not candidates for anthracycline-based therapy, concludes Pagel.