Andrés López Hernández, hematologist at the Vall d’Hebron University Hospital.
The treatment for diffuse large B-cell lymphoma has experienced a paradigm shift with the appearance of new drugs y therapeutic strategiesmainly motivated by the new generations of CAR-T therapy. All these advances have been published in a guide generated by the Spanish Group of Lymphomas and Bone Marrow Transplants (Geltamo), although they are still insufficient for a significant number of patients who are incurable with current therapies.
Andres Lopez Hernandezhematologist at the University Hospital Hebron Valley and one of the authors of the guide, states in ‘Medical Writing‘ that “one of the main novelties that the approach to this lymphoma has undergone is the appearance of CAR-T, and mainly the repercussion it is having on relapsed patients. Vall d’Hebrón is one of the centers that has tried the most with this therapysince it is considered a alternative treatment important for these patients.
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“We need to find alternatives for patients who are not cured with CAR-T” |
Despite the great results that this type of immunotherapy has offered, CAR-T are not a panacea, since, in the words of López, “in the long term, they rescue the 30 or 40 percent of patients, while we need to find therapeutic alternatives for the rest. We must look at other types of immunotherapy and they are currently being done bispecific antibodies attached to a certain molecule to be used in clinical trials. They are combinations that become important and they can lead to rescuing those patients that has been impossible with CAR-T therapy.”
Another aspect highlighted by the hematologist is that some active clinical trials seek to improve the results of CAR-T in order to achieve more effective treatments for diffuse large B-cell lymphoma: “We know that certain drugs used previousa posteriori o together with this therapy we can improve the results. exist already inhibitors that are beginning to be given by CAR-T”.
Precision medicine ineffective once morest lymphoma
Although the immunotherapy has taken an important turn in the treatment of this lymphoma, the appearance of new drugs has caused medicine, according to the hematologist, “to be much more cara. You have to select the patient who really can answer better. The most important thing is to know which niche is going to go best. It is very important to choose the patient to have the maximum guarantees that we are being effective”.
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“The means we have do not tell us which patients can do well applying precision medicine” |
The precision medicine It is the other great ally when it comes to rescuing patients with this pathology, although hematologists continue to run into obstacles along the way. “We have managed to detect a genetic alteration in this type of lymphomas and we direct the treatment with a stay inhibitor. In this lymphoma it has not given the expected result, because we do not know which of the patients we have to select with certainty to give this type of treatment. The media what we have so far they don’t tell us which are the patients that can do well in this sense”, explains the Vall d’Hebrón specialist.
One of the peculiarities of the guide made by several Geltamo specialists is your dynamism y ease to adapt to the new research. “Every time there is an important event that can be incorporated into the therapy of these patients, the entire group that has prepared the guide can meet, analyze it and it really is a therapy to be able to advise, it can be incorporated immediately without the need to make a new guide”, states López.
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