OnkoCafe Foundation and HematoKoalition: 2023 should be the year of lymphoma

Lymphomas are the most common blood cancers with widely varying types and courses. Some lymphomas are very aggressive and, in the absence of treatment, can lead to the death of the patient in just a few weeks, while others can be lived with many times longer. Modern therapies have greatly improved the situation of patients with lymphomas, so that not only can the disease be controlled or function better, but sometimes they even offer a chance for a permanent cure. The time has come to take comprehensive care of the system of care for this group of patients.

In line with recent trends in oncology, we are increasingly reaching for the most effective forms of treatment in the early lines. This approach increases patients' chances of a longer life and a better quality of life. It also means a better chance of a permanent cure.

- For diffuse large B-cell lymphoma (DLBCL), one of the most aggressive and common non-Hodgkin's lymphomas, the best results come from first-line immunochemotherapy. There has been a lot of buzz about this treatment recently, as the first regimen in more than 20 years has emerged that is more effective than the current standard. And although we are dealing with an aggressive disease, the responses to modern treatment are long-lasting and one can even speak of curing the disease. That's why patients are appealing to take care, first of all, precisely of the modern therapeutic options in the first line, as increasing the percentage of sustained responses will reduce the group of people requiring subsequent lines of treatment," says Anna Kupiecka.

Another case of aggressive cancer of the lymphatic system is mantle cell lymphoma. In this case, too, the disease usually has a violent course and can lead to the death of the patient within a few months or so. Among the treatment methods used is immunochemotherapy, but it does not have the expected effect in every case.

- In patients who have the TP 53 mutation, we can quickly see resistance to treatment. In such cases, recommendations from international scientific societies recommend the use of Bruton's kinase inhibitors. Unfortunately, in Poland, they are not yet available for patients with refractory and relapsed mantle cell lymphoma outside the system of rescue access to drug technologies, where the administrative procedure is long and not always feasible. The optimal solution would be to gain access to this treatment under the drug program, comments Prof. Iwona Hus, president of the Polish Society of Hematologists and Transfusionists.

In the case of lymphomas, there are also less aggressive, which does not mean less burdensome for patients, types of the disease. Among them, for example, we can mention lobular lymphoma. The disease is characterized by a rather slow progression, but often does not give typical symptoms either. Thus, it is sometimes detected at an advanced stage. Treatment in this case is long-lasting and consists primarily of trying to control the disease and ensuring the longest possible periods of remission.

- Treatment of follicular lymphoma is often a process that is spread out over years. Patients may even have several relapses with the risk of transformation to an aggressive form. With this in mind, it is essential for treatment to have as wide access as possible to various forms of treatment and to include multiple lines, where we should be able to offer patients modern and effective therapies. However, currently in Poland, in the case of lymphoma nodosa, we can only talk about securing the first 2 lines of treatment," says Anna Kupiecka.

Clinical experts see an opportunity to improve the situation for patients with relapsed and advanced lymphoma of the lobular type in treatment with a monoclonal antibody. The drug in question is mosunetuzumab, which at the moment is highest on the priority list of as-yet-unreimbursed molecules on Hemato's TOP 10 list. Although the group of patients requiring treatment is not large, they are very much looking forward to accessing this therapy, which offers the hope of significantly extending the time without disease progression.

- In recent years, many new molecules have been introduced in hematooncology, which has greatly increased the possibilities for modern treatment of many blood cancers. It is important to emphasize the tremendous work that the Ministry of Health has managed to do in cooperation with the national consultant, for example, in the treatment of leukemia. In some areas, however, we are still waiting for urgent medical needs and access to new therapies to be met. We are talking, for example, about lymphomas, where a number of therapies have emerged in recent years that could change the face of lymphoid malignancies. Patients are very much looking forward to accessing treatment, and as is the case with this type of disease, they have no time to wait. I wish them and would very much like 2023 to be the year of lymphomas," concludes Anna Kupiecka.

Source: OnkoCafe Foundation