Lymphoma clinical trials

Clinical trials are research studies that evaluate whether a new drug, treatment, or combination of treatments is safe, effective and possibly better than the current standard-of-care.  Today, they are how science is used to prove new treatments safety and effectiveness against current treatments. Almost all cancer drugs being used today to help patients were tested and released through clinical trials.

It is important to investigate all of your treatment options especially for those whose cancer has not responded to standard treatments.

Lymphomas are referred to as “blood” cancer or “liquid” tumors

 Lymphoma 

Lymphomas are cancers that develop in the blood and lymphatic system. They are commonly referred to as “blood” cancer or “liquid tumors” rather than solid tumor like breast, prostate, colon, etc. Lymphomas have two main types- Hodgkin lymphoma and non-Hodgkin lymphoma (NHL).

Hodgkin lymphoma can be found in the blood and bone marrow. It is distinctive from other lymphomas largely due to the presence of large cancerous cells called Reed-Sternberg cells.  Hodgkin lymphoma is one of the most curable forms of cancer.

Non-Hodgkin lymphoma (NHL) is a group of over 30 cancers that affect the lymphatic system and  generally develops in the lymph nodes and lymphatic tissues although sometimes also in the blood and bone marrow. NHL develops when there is a an abnormal change in a white cell in a lymph node or lymphoid tissue called alymphocyte. The abnormal cell grows uncontrollably and reproduces other abnormal cells, resulting in tumors.  These abnormal cells overwhelm the normal white cells that defend the body against infection, and via the lymph system spread to other area of the body.  This can happen in 3 types of lymphocytes which give rise to the NHL subtypes and treatments that are based in this origin:

  • B lymphocytes (B cells)- which produce antibodies to help combat infections (represent about 85% of NHL diagnoses)
  • T lymphocytes (T cells)- multiple functions, help B lymphocytes make antibodies
  • Natural killer (NK) cells- attack virus-infected cells or tumor cells Learn more from the Leukemia & Lymphoma Society

The most common types of NHL in adults are diffuse large B-cell lymphoma (a more aggressive form) and follicular lymphoma (a slower or“indolent” form). More rare types are mycosis fungoides and Sézary syndrome that start in the blood cells in the skin and others that start in white blood cells in the brain, spinal cord, or eye. Learn more from the Leukemia & Lymphoma Society

History of Lymphoma Research

Hodgkin and NHL are named after Thomas Hodgkin, who in 1832, recognized abnormalities in the lymphatic system, although it may have been described by others as early as 1666.  He studied seven patients who had enlarged but painless lymph nodes, and presented his findings to the Medical and Chirurgical Society in London in 1832, and his findings were subsequently published.  In 1856, Samuel Wilks reported on a further set of patients with the same disease described by Hodgkin, and it was not until 1965 that he published a paper calling the condition “Hodgkin’s disease,” in honor of Hodgkin. In 1872, Hodgkin’s lymphoma was seen at the microscopic level, and the significance of Reed-Sternberg cells were discovered in 1898.

The first known treatment for Hodgkin’s lymphoma was a medicine containing arsenic in 1894. In 1932, radiation therapy was starting to be utilized, but mainly for palliative purposes. Two pharmacologists noticed that mustard gas used in WW1 lowered blood counts and destroyed lymph nodes in soldiers who were exposed to the gas, and began looking at mustard gas as a possible treatment for lymphoma. Two decades after the war, a thoracic surgeon named Gustav Lindskog used nitrogen mustard to successfully treat a patient with NHL,  giving rise to the first “chemotherapy” agents. In 1963, a combination of chemotherapy agents was developed, which consisted of cyclophosphamide, vincristine, methotrexate, and prednisone. Another drug regimen was introduced in 1987 called EBVP (epirubicin, bleomycin, vinblastine, prednisone).  In 1992, the German Hodgkin’s Study Group designed the BEACOPP regimen which involved the use of seven chemotherapy agents, namely bleomycin, etoposide, adriamycin, cyclophosphamide, oncovin, procarbazine and prednisone. An additional treatment developed was bone marrow transplant, but this procedure has had challenges with complications and access.  Patients now have a number of therapy options that include different forms of chemotherapy, radiotherapy bone marrow transplant, stem cell, and newer targeted drugs. Learn more from News Medical

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Current Lymphoma Research

Scientists have been working to advance their understanding of how normal lymphocytes develop into lymphoma cells, and the role of DNA mutations. These mutations may allow the cells to grow rapidly, resist cell death, and resist maturation into cells that take part in normal immune reactions. Drugs can be targeted to these growth processes once the mechanisms for abnormal growth are identified.

Genetic tests have been developed to identify DNA changes that can cause disease. Such tests can identify lymphoma cells based on changes such as chromosome translocations or rearrangements, or specific gene mutations. These tests can detect lymphoma in biopsies and determine the type so treatments can be more targeted, help predict growth rate, and measure treatment success and chance of relapse. Learn More from the National Cancer Institute

Progress is being made in bone marrow and peripheral blood stem cell transplant methods, both for donor and autologous (self) transplants.  Researchers are working on new ways to collect these cells before the transplant to reduce risk of reintroducing the cancer after treatment as well as ways to remove the last traces of cancerous cells from the stem cells before they are returned to the patient. This may be more successful by using some of the newer drugs for treating lymphoma such as monoclonal antibdody therapies. Eliminating graft-versus-host disease (transplanted T-cells attack the body) is also under development so that the transplanted T-cells kill the lymphoma cells, without attacking the immune system.

As researchers gain insight into lymphoma cells they are developing drugs that target specific parts of these cells, that may result in fewer side effects, and be effective when chemotherapy fails. Monocolonal antibodies are a type of immunotherapy that targets specific proteins on the lymphoma cell surface or use antibodies to direct drugs into the cancer cells to destroy them while causing little damage to normal body tissues. Other potential treatments include antibiotics, vaccines and chemotherapy combinations.  There are many current clinical trials that are testing these newer therapies and that provide new hope for lymphoma patients. Learn more from the American Society of Clinical Oncology

Genetic tests can detect lymphoma in biopsies and determine the type.

This can help make treatments more targeted and growth rates more predictable.

Why Cure Forward?

Finding information about lymphoma clinical trials or other relevant studies can be difficult and frustrating.

We aim to make this easier.  Through our Clinical Trial Exchange, Cure Forward collects data on clinical trials and studies from multiple sources so that you can find options that are available for you or your loved one in one place.  We work directly with clinical trial recruiters and update the trials available often to bring current, active studies directly to you.

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