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Prognostic molecular biomarkers in diffuse large B-cell lymphoma in the rituximab era and their therapeutic implications

Diffuse large B-cell lymphoma (DLBCL) represents a group of tumors characterized by substantial heterogeneity in terms of their pathological and biological features, a causal factor of their varied clinical outcome. This variation has persisted despite the implementation of rituximab in treatment re...

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Autores principales: Papageorgiou, Sotirios G., Thomopoulos, Thomas P., Katagas, Ioannis, Bouchla, Anthi, Pappa, Vassiliki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8150462/
https://www.ncbi.nlm.nih.gov/pubmed/34104369
http://dx.doi.org/10.1177/20406207211013987
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author Papageorgiou, Sotirios G.
Thomopoulos, Thomas P.
Katagas, Ioannis
Bouchla, Anthi
Pappa, Vassiliki
author_facet Papageorgiou, Sotirios G.
Thomopoulos, Thomas P.
Katagas, Ioannis
Bouchla, Anthi
Pappa, Vassiliki
author_sort Papageorgiou, Sotirios G.
collection PubMed
description Diffuse large B-cell lymphoma (DLBCL) represents a group of tumors characterized by substantial heterogeneity in terms of their pathological and biological features, a causal factor of their varied clinical outcome. This variation has persisted despite the implementation of rituximab in treatment regimens over the last 20 years. In this context, prognostic biomarkers are of great importance in order to identify high-risk patients that might benefit from treatment intensification or the introduction of novel therapeutic agents. Herein, we review current knowledge on specific immunohistochemical or genetic biomarkers that might be useful in clinical practice. Gene-expression profiling is a tool of special consideration in this effort, as it has enriched our understanding of DLBCL biology and has allowed for the classification of DLBCL by cell-of-origin as well as by more elaborate molecular signatures based on distinct gene-expression profiles. These subgroups might outperform individual biomarkers in terms of prognostication; however, their use in clinical practice is still limited. Moreover, the underappreciated role of the tumor microenvironment in DLBCL prognosis is discussed in terms of prognostic gene-expression signatures, as well as in terms of individual biomarkers of prognostic significance. Finally, the efficacy of novel therapeutic agents for the treatment of DLBCL patients are discussed and an evidence-based therapeutic approach by specific genetic subgroup is suggested.
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spelling pubmed-81504622021-06-07 Prognostic molecular biomarkers in diffuse large B-cell lymphoma in the rituximab era and their therapeutic implications Papageorgiou, Sotirios G. Thomopoulos, Thomas P. Katagas, Ioannis Bouchla, Anthi Pappa, Vassiliki Ther Adv Hematol Review Diffuse large B-cell lymphoma (DLBCL) represents a group of tumors characterized by substantial heterogeneity in terms of their pathological and biological features, a causal factor of their varied clinical outcome. This variation has persisted despite the implementation of rituximab in treatment regimens over the last 20 years. In this context, prognostic biomarkers are of great importance in order to identify high-risk patients that might benefit from treatment intensification or the introduction of novel therapeutic agents. Herein, we review current knowledge on specific immunohistochemical or genetic biomarkers that might be useful in clinical practice. Gene-expression profiling is a tool of special consideration in this effort, as it has enriched our understanding of DLBCL biology and has allowed for the classification of DLBCL by cell-of-origin as well as by more elaborate molecular signatures based on distinct gene-expression profiles. These subgroups might outperform individual biomarkers in terms of prognostication; however, their use in clinical practice is still limited. Moreover, the underappreciated role of the tumor microenvironment in DLBCL prognosis is discussed in terms of prognostic gene-expression signatures, as well as in terms of individual biomarkers of prognostic significance. Finally, the efficacy of novel therapeutic agents for the treatment of DLBCL patients are discussed and an evidence-based therapeutic approach by specific genetic subgroup is suggested. SAGE Publications 2021-05-24 /pmc/articles/PMC8150462/ /pubmed/34104369 http://dx.doi.org/10.1177/20406207211013987 Text en © The Author(s), 2021 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Review
Papageorgiou, Sotirios G.
Thomopoulos, Thomas P.
Katagas, Ioannis
Bouchla, Anthi
Pappa, Vassiliki
Prognostic molecular biomarkers in diffuse large B-cell lymphoma in the rituximab era and their therapeutic implications
title Prognostic molecular biomarkers in diffuse large B-cell lymphoma in the rituximab era and their therapeutic implications
title_full Prognostic molecular biomarkers in diffuse large B-cell lymphoma in the rituximab era and their therapeutic implications
title_fullStr Prognostic molecular biomarkers in diffuse large B-cell lymphoma in the rituximab era and their therapeutic implications
title_full_unstemmed Prognostic molecular biomarkers in diffuse large B-cell lymphoma in the rituximab era and their therapeutic implications
title_short Prognostic molecular biomarkers in diffuse large B-cell lymphoma in the rituximab era and their therapeutic implications
title_sort prognostic molecular biomarkers in diffuse large b-cell lymphoma in the rituximab era and their therapeutic implications
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8150462/
https://www.ncbi.nlm.nih.gov/pubmed/34104369
http://dx.doi.org/10.1177/20406207211013987
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