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- At the head of the node: a new approach has tripled the effectiveness of lymphoma treatment
At the head of the node: a new approach has tripled the effectiveness of lymphoma treatment
Russian doctors have developed a new approach to treating one of the most common and aggressive types of lymphoma. Thanks to genetic analysis, doctors were able to add to standard chemotherapy targeting drugs specific to a particular patient's tumor. As a result, the experimental group was able to achieve remission in more than 90% of cases. Previously, the therapy was effective in only a third of patients. According to practicing oncologists, the technique is extremely promising. In the near future, experts plan to continue experiments on a wider sample of patients.
Treatment of lymphoma
Specialists of Sechenov University have begun to apply a new approach to the treatment of diffuse B-cell large cell lymphoma. Thanks to the use of genetic analysis, doctors were able to determine the subtype of the tumor, which allowed them to prescribe personalized therapy to patients. As a result, doctors were able to triple the effectiveness of the fight against this deadly disease.
- The possibility of a personalized approach came as a result of the work done by scientists and clinicians. Separate subtypes of malignant lymphomas were differentiated, which made it possible to choose the optimal targeting drug for the course of chemotherapy. In the treatment of aggressive lymphomas, it is necessary to achieve maximum response in the first stages of treatment. The new personalized approach will increase the percentage of achieving complete remissions in the first line of therapy, - said the head of the Department of Hematology at the N.V. Sklifosov Institute of Clinical Medicine. N.V. Sklifosovsky Institute of Clinical Medicine of Sechenov University and head of the hematology center of Municipal Clinical Hospital No. 52 of the Moscow Department of Public Health Elena Misyurina.
Diffuse B-cell large cell lymphoma (DBCL) is a malignant tumor in which uncontrolled division of tumor lymphocytes occurs in lymph nodes. It is considered one of the most aggressive and common forms among a large group of similar pathologies, which are called non-Hodgkin's lymphomas. The disease is characterized by many different clinical manifestations, which are very rapidly progressing. The average age of patients is 60 years.
A new approach to therapy medics tested on a group of 30 volunteers with this diagnosis. It included patients with a high international prognostic index, which means an unfavorable prognosis for survival. Before treatment, the patients were collected for molecular typing of the tumor. They were then given one course of standard chemotherapy. While the treatment was underway, the medics performed genomic sequencing and determined the molecular subtypes of the lymphoma. Then, depending on it, four drugs were added to the therapy: acalabrutenib, decitabine, vorinostat and lenaledomide.
- There are now 30 patients in this group, mostly with generalized stages of the disease (when the disease has spread beyond a single focus). We did not have any special selection, any selection by age. To date, 21 people have already completed therapy, the overall response rate was 95-100%. Nine patients are still in the process of therapy, eight of them have also achieved a complete response, - said Elena Baryakh, Professor of the Department of Hematology at the N.V. Sklifosovsky Institute of Clinical Medicine of Sechenov University, Head of the Department of Hematology and Chemotherapy at Municipal Clinical Hospital No. 52.
Previously, standard therapy was effective only in one third of patients.
New method
The specialist also described one of the real clinical cases. According to her, in December 2023, a 44-year-old patient was admitted to the hospital. Before that, for a year, the woman felt an increase in lymph nodes, but refused diagnosis.
- Using biopsy and CT scan, the patient was found to have DBKL with peripheral pelvic lymph node involvement involving the spleen, right kidney, pancreas, ovaries, mammary glands, left lateral neck, vertebrae, pelvic bones, sacrum, peripheral soft tissue of the back skin and anterior chest wall. This is stage 4, high risk. The patient was included in our grant and went all the way through to determine the genetic subtype, and we started therapy in February of this year. Today she is in remission and under the supervision of doctors, - said Elena Baryakh.
Elena Baryakh
The work was carried out under the grant of the Moscow government, received by the medics in February 2023. The research will be continued on a larger sample of patients.
- Now it is a new trend, when to the basic most effective therapy add specific treatment and drugs aimed at a specific subtype of the disease. There are six of these in total. It's more specific than conventional chemo. It is a promising technique and researchers have shown good results," said Alexei Maschan, deputy director of the Federal Center for Pediatric Hematology, Oncology and Immunology.
According to Vadim Pokrovsky, Head of the Department of Biochemistry named after Academician T.T. Berezov of the Russian Academy of Medical Sciences, the method allows targeted administration of targeted drugs and expands the possibilities of their use. However, the specialist does not see anything fundamentally new in the proposed approach.
