Sunday, December 29, 2013

Follicular Lymphoma and Genetic Profiling

Interesting and encouraging news from the journal Nature Genetics:  new research from Britain gives an even more complete picture of the genetic mutations involved in Follicular Lymphoma, including transformation.

I'll be honest -- I haven't read the full article. I don't get free access for a few months, and they want $32 for a copy of the article. I can't afford it at this time of year. Spent my last $10 on a handmade nose warmer for my wife. (Not really, but her sister did buy her one, and she loves it.)

So I'm getting my information from a report from MedicalXpress and from the abstract for the original article. But even those less-than-ideal sources show that there seems to be some really good stuff from this research.

The researchers did a series of genetic analyses of the DNA of a single patient as his or her disease progressed over time. By doing this, they were able to map out the initial genetic mutations, but also see if any new ones popped up when this patient transformed from indolent Follicular Lymphoma to a more aggressive form.

What the researchers hope is that they have found a number of mutations that can help them target FL at a number of stages: at the initial onset of the disease; when it begins to resist treatment (which happens for most patients, which is why we need to switch to different treatments along the way); and at transformation. Much of the newer research is very targeted to genetic mutations, so it's possible that different treatments could be created to deal with Follicular Lymphoma at these different stages.

In case you're wondering, the specific mutations were identified include those in linker histones (histones are the proteins that the DNA winds itself around to form a spiral shape; linker histones kind of seal of the ends of the spiral); JAK-STAT signaling pathways (this is one of those Kinase things that are, in general, an important part of FL research these days); and NF-κB signaling (a bunch of proteins that are involved with transcribing DNA, making sure it gets copied correctly when a cell divides). Plus some others. You know, just in case you were wondering. (I love you little cancer nerds who bothered to read to the end of the paragraph.)

Very important early research, but with the usual cold water:
First, it is indeed early research. They've identified the mutations. It will likely take years to find treatments that will target these mutations, and then more years to test them in trials and get them approved.
Second, this is the DNA of a single patient. We know how complex cancer is, and it is probable that these are not the only mutations that lead to Follicular Lymphoma, or resistance to treatment, or transformation. But it's a good model to follow on other patients to get a bigger picture.

So, as always, we shake off the cold water and towel ourselves off with a little more hope for the future.

Good stuff.

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