Friday, March 20, 2015

Biomarkers in Follicular Lymphoma

I'm feeling guilty because I've been so bad about posting things to the blog. Work is busy and family obligations are abundant. I'm still in physical therapy for my shoulder, which is disrupting my schedule even more.

To be honest, I'm feeling kind of disconnected from my cancer. No time to read and write about it, and I still haven't heard anything from whoever my new oncologist is. I guess that's good, in a way -- it's been a long time since I've obsessed over my health, and I prefer it that way. But I don't want to go too far the other way, either, and put it out of my mind completely. Avoidance is not a coping strategy. I like that happy middle -- learning as much as I can about Follicular Lymphoma and sharing it, and taking comfort from that.

I'll try to get back on track.


OncLive, a web site for the oncology community, posted an interview this week Dr. Randy Gascoyne from the British Columbia Cancer Agency in Canada. Dr. Gascoyne is researching predictive biomarkers in Follicular Lymphoma and DLBCL.

Biomarkers are things like proteins or genes that are present on specific types of cancer cells. There are several already identified for Follicular Lymphoma; Dr. Gascoyne is working on identifying even more. Sometimes this involves finding a biomarker that might disturb a pathway. In other words, something on an FL cell is necessary for something else to happen that keeps the cancer cell alive. Identifying that marker, understanding its role in cell survival, and then finding how to mess with it -- that's what scientists are really excited about (and what they are having some success with recently).

So, for example, Dr. Gascoyne described a study that looks at FLIPI, a tool used by oncologists to measure how aggressive they should be with treatment. (See for a nice explanation of FLIPI.) But FLIPI is a very general tool, and about a quarter of patients in his study did worse than predicted.  Dr. Gascoyne identified seven genes that, when present, can predict more accurately than FLIPI alone that a patient is probably going to have big problems.

The next step is to use that information to design treatments that take into account those genetic markers. Certain treatments can be targeted to those patients right away (assuming they have been shown to work on those patients).

This kind of work is already happening in Follicular Lymphoma, and Dr. Gascoyne thinks even more will happen in the future. He looks forward to this work being more predictive -- showing a strong connection between particular biomarkers and eventual treatments.

Lots of good stuff on the horizon.

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