Stephen M. Ansell, MD, Ph.D. from the Mayo Clinic, Rochester speaks about the review: Checkpoint BLOCKade in Lymphoma.
Link To Paper –
https://ascopubs.org/doi/abs/10.1200/JCO.20.01522
Instract
Along with advances in genomic research, the clinical development of successful cancer immunotherapies has led to the discovery of tumor environmental characteristics that predict susceptibility to immune control point blockade therapy (CBT). The remarkable efficacy of CBT in various lymphoma subtypes, including classical Hodgkin lymphoma and primary mediastinal B-cell lymphoma, has been demonstrated in early-phase clinical trial findings. Conversely, for follicular lymphoma and diffuse large B-cell lymphoma, CBT has been relatively disappointing. Together with significant scientific findings, these clinical studies have revealed salient features of the lymphoma microenvironment that correlate with patients’ immunotherapy response. Classical Hodgkin lymphoma, for example, is characterized by an inflammatory environment, genetic modifications that promote escape from immune attack, and susceptibility to treatment with PD-1 blockade. On the other hand, anti-PD-1 therapy has proven less effective for lymphomas in which immune surveillance measures are missing, including follicular lymphoma and most diffuse large B-cell lymphomas. To identify subsets that could benefit from CBT, an enhanced understanding of the immune landscapes of these lymphomas is needed. In this article, with a focus on the immune escape mechanisms orchestrated by these diseases, we identify the immune environments associated with major B-cell lymphomas. We also discuss how oncogenic changes in lymphoma cells can affect the immune environment’s cellular composition and, ultimately, vulnerability to CBT. Finally, key areas for future investigations have been highlighted, including the need to establish biomarkers that predict CBT sensitivity in patients with lymphoma.