ASCO: Follicular Lymphoma Transformation

One more from ASCO: "Changes in the Tumor Microenvironment Associated with Transformation in Follicular Lymphoma," from researchers at the Mayo Clinic.



There's been more and more interest in Microenvironments in the last few years. Microenvironments are, basically, the stuff that immediately surrounds a cancer cell. The idea is that maybe it's not just the cancer cells that need to be taken care of. Maybe it's the way that they interact with what's around them -- maybe there are little enablers hanging around that make things worse.

Transformation is, of course, a Follicular Lymphoma patient's worst fear -- that our nice slow-growing cancer will turn into a nasty fast-growing cancer. It happens to anywhere from 15-50% of us (depending on who you ask). The question is, Does transformation come about because of the nature of the cells themselves? Or is it some other kind of interaction with the cells that makes them more likely to transform?

The Mayo researchers identified seven different elements in the microenvironment that could possible have an affect on transformation. They ultimately identified two elements that seem to predict a short period before transformation (CD14+, a type of white blood cell, and PD-1+, a protein that plays a role in cell death). It seems like fairly early research, but certainly something worth keeping an eye on. No discussion on the clinical applications of this, but I could see maybe testing of some type to identify susceptibility to transformation, with the aim of catching it early (?).

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Overall, this ASCO has been a little disappointing in a way. No real blockbusters in the Follicular Lymphoma category, and not many in the broader Lymphoma category, either. I usually see a wave of press releases touting the significance of the presentations, but it's all been pretty quiet. Maybe Patient Power or Medscape will offer some kind of review in the next few weeks, with some Lymphoma Rock Star getting me all excited about the long-term significance of a small study.

I could go for that.