Wednesday, December 31, 2014

Biggest Follicular Lymphoma Story of 2014

Last year, on the eve of the new year, I gave you my 10 "Best of 2013" stories for Follicular Lymphoma. As much as I'd like to do that again, it's not going to happen. Frankly, it's too much work. And in a year when wrote about 30 fewer posts than the year before, it just seems appropriate that I take the lazy way out at the end of this year, and give you my one Biggest Story instead of a Top 10.

There were some worthy candidates, for sure. Early in the year, we got the FDA approval for Idelalisib for Indolent/Follicular Lymphoma, through a "Breakthrough Therapy" designation. Very significant for both the promise of the treatment and for the FDA designation.There was good news in the spring for R + R, and for Velcade, both coming out of the ASCO conference. Bunch of stuff on vaccines, and tons on various inhibitors.

Then, of course, there's the big story on me personally: my biggest health problem of the year is not my lymphoma. (My shoulder, by the way, is doing well. Range of motion and strength are almost completely returned -- a very happy outcome, given my age and the damage I did.)

So, there's lots of good stuff in the world of Follicular Lymphoma this year. Lots that we can be hopeful about.

However, the one thing that continues to guve me the most hope is this:


This isn't about one particular treatment, but instead a general approach -- trying to get the body's immune system to fight cancer on its own, instead of mistakenly recognizing cancer as something that's OK to let hang around. That can happen in a lot of ways.

Last year, the journal Science named Immunotherapy its "Breakthrough of the Year for 2013," and I'm aware that Immunotherapy isn't something new to this year. But a lot of the stuff I highlighted all year (including some of the stuff above) falls under the heading "Immunotherapy." (I'm going to send you, once again, to, if you want to know more about Immunotherapy.)

You want the line up? Monoclonal Antibodies, like Rituxan and some of the newer ones like Ofatumumab, are all considered Immunotherapies. (Not to mention to RadioImmunoTherapies that rely on MABs to find FL cells.) So are T-cell therapies, like Chimeric Antigen Receptor T-Cells (CAR-T). And so is Lenalidomide, the other R in R + R (it's also known as Revlimid). 

Really, most of the stuff that gets experts excited falls under Immunotherapy in some way. It's how we will deal with Follicular Lymphoma (and most cancers) for the foreseeable future: targeted treatments that work with the immune system to shut down cancer.

After the ASH conference this year, most of the press releases that I saw from research centers and pharma companies were touting the results of research on Immunotherapy of some kind. Arguably the biggest news to come out of ASH this year dealt with Immunotherapy approaches to Hodgkin's Lymphoma: two different treatments that targeted PD-1 had great responses from HL patients.

And if you aren't excited about Hodgkin's, there's the CAR-T results from a small trial at UPenn that showed a 100% response rate for Follicular Lymphoma patients....


Immunotherapy isn't new, and it isn't one particular thing,and it's probably  a ways off before it replaces what we have now. And depsite that UPenn result, nothing is 100% effective -- not yet, anyway.

But on New Year's Eve, as we look back over our (surgically-repaired) shoulder, and think about the past, we look quickly ahead to the future. There's a lot to be hopeful about. New perspectives, new approaches, new results.

I wish you all, once again, much joy and peace in the new year. I thank you for reading over the last 12 months, and I look forward to sharing more great news with you in 2015.


Anonymous said...

Hi Bob--
Thanks for pointing to PAL!
Please contact Karl at Lymphomation, perhaps we can collaborate in some way

Lymphomaniac said...

Thanks, Anjou -- I will do that.