Research in non-Hodgkin lymphoma

We are always learning more about cancer. Researchers and healthcare professionals use what they learn from research studies to develop better practices that will help prevent, find and treat non-Hodgkin lymphoma (NHL). They are also looking for ways to improve the quality of life of people with NHL.

The following is a selection of research showing promise for NHL. We’ve included information from PubMed, which is the research database of the National Library of Medicine. Each research article in PubMed has an identity number (called a PMID) that links to a brief overview (called an abstract).

A key area of research looks at trying to find ways to help doctors predict a prognosis (the probability that the cancer can be successfully treated or that it will come back after treatment). The following is noteworthy research into prognosis for NHL.

PET scans may be used to identify areas in the body that are affected by NHL and to help monitor how treatment is working. Researchers looked at using PET scans before and after autologous stem cell transplants (ASCT) to see if the results could predict a prognosis. If a person did not have areas of NHL found during the scan, it was a negative scan. Positive scans found areas of NHL in the body. The study showed that negative PET scan results taken after ASCT predicted a prognosis better than negative scans taken before ASCT. People with negative PET scans had longer progression-free survival and overall survival than people with positive PET scans (Chinese Journal of Cancer Research, PMID 29353979).

Researchers are looking for new ways to improve treatment for NHL. Advances in cancer treatment and new ways to manage the side effects from treatment have improved the outlook and quality of life for many people with cancer. The following is noteworthy research into treatment for NHL.

High-dose chemotherapy with ASCT is used to treat some types of NHL. The high-dose chemotherapy given before ASCT can affect survival and quality of life. Different types of NHL can respond differently to different chemotherapy regimens. Researchers are looking at the impact of different high-dose chemotherapy regimens on outcomes for people with NHL (Clinical Lymphoma, Myeloma and Leukemia, PMID 29500148, PMID 28870642).

Research shows that high-dose chemotherapy with ASCT may be a better treatment option for people with primary central nervous system lymphoma (PCNSL) than current treatments using high-dose methotrexate-based chemotherapy (Cancer, PMID 25204639; Blood, PMID 25568347; Leukemia and Lymphoma, PMID 25747968).

Researchers looked at the combination of oxaliplatin (Eloxatin), cytosine arabinoside and dexamethasone (Decadron, Dexasone) with rituximab (Rituxan), which is an immunotherapy drug. They wanted to see if this combination is effective in treating B-cell NHL that has the CD20 protein (called CD20-positive, or CD20+, NHL) and has relapsed. Study results show that 69% of the people who were given ASCT after this combination were still alive after 5 years (American Journal of Hematology, PMID 28614905).

Researchers are looking at better ways of using radiation therapy to treat NHL.

Radioimmunotherapy combines radiation therapy with targeted therapy. A radioactive material is attached to a substance that targets specific molecules (such as proteins) on the surface of cancer cells. The drug attaches to the cancer cells so the radiation is delivered directly to them, which may mean fewer or less severe side effects. Currently radioimmunotherapy is used as a treatment for NHL after chemotherapy stops working. Some researchers trying to find out if it could be used as the first treatment for NHL, saving chemotherapy for second-line or later treatments (Immunotherapy, PMID 29569511).

Proton beam radiation therapy uses high-energy, or charged, proton particles. Doctors can aim these more precisely at the tumour than the x-ray beams used in conventional radiation therapy. Researchers hope that using proton beam radiation therapy to treat NHL will reduce side effects from radiation therapy (Leukemia and Lymphoma, PMID 25669925).

Immunotherapy helps strengthen or restore the immune system’s ability to fight cancer. Researchers are studying different types of immunotherapy drugs to treat NHL.

Monoclonal antibodies are both a type of immunotherapy and a targeted therapy. They bind to specific antigens on cancer cells to help destroy them. Some monoclonal antibodies that are showing promise in treating NHL include:

• blinatumomab (Blincyto) (Expert Opinion on Drug Safety, PMID 28825327; Expert Opinion on Biological Therapy, PMID 28532177)
• otlertuzumab (Advances in Therapy, PMID 28004361)
• mogamulizumab (Expert Opinion on Biological Therapy, PMID 28649848)
• ublituximab (British Journal of Haematology, PMID 28220479)

T cells are part of the immune system. They help fight infection and destroy abnormal cells, including cancer cells. Doctors take T cells from a person’s blood and genetically engineer, or modify, them in the lab so they have chimeric antigen receptors (CARs) on their surface. CARs are proteins that make the T cell recognize cancer cells. Doctors can grow CAR T cells in the lab until they have billions of them. They then infuse the CAR T cells back into the person’s blood, where they will multiply and then target and kill cancer cells. Researchers have found that engineered CAR T cells are effective in treating NHL (Journal of the National Comprehensive Cancer Network, PMID 29118234). Axicabtagene ciloleucel is one particular CAR T cell therapy drug that shows promise as a treatment for diffuse large B-cell lymphoma (Leukemia and Lymphoma, PMID 29058502).

Researchers continue to try to find out more about NHL. Clinical trials are research studies that test new ways to prevent, detect, treat or manage NHL. Clinical trials provide information about the safety and effectiveness of new approaches to see if they should become widely available. Most of the standard treatments for NHL were first shown to be effective through clinical trials.

Find out more about clinical trials.