People with follicular lymphoma who are in remission for at least two years following treatment may no longer show detectable signs of the disease or possibly be cured.
That finding was presented in a poster, “Long-Term Follow-up of Follicular Lymphoma (FL) Patients (pts) Demonstrating Undetectable Minimal Residual Disease (MRD) Using a Next-Generation Based DNA Assay: Support for FL As a Curable Disease,” at the 2019 American Society of Hematology (ASH) Annual Meeting in Orlando, Florida.
Follicular lymphoma is the most common slow-growing form of non-Hodgkin’s lymphoma (NHL). While it is not the most aggressive type of lymphoma, follicular lymphoma is highly recurring and has been considered incurable by some.
However, data from a new study carried out by investigators from the Georgetown Lombardi Comprehensive Cancer Center in Washington, D.C., is suggesting that for those who are in remission for more than two years, there is a chance the disease will never return.
“While follicular lymphoma is not one of the more aggressive types of cancer we treat, the majority of patients continue to experience disease recurrence over many years and have to receive different types of therapy,” Maryam Sarraf Yazdy, MD, said in a press release. Yazdy is a hematologist/oncologist at MedStar Georgetown University Hospital and Georgetown Lombardi.
“This disease has been considered incurable, but for some patients who have been disease-free for at least two years after remission, our pilot study gives hope that calling the disease incurable may no longer be accurate,” Yazdy said.
In the study, investigators analyzed biopsy samples taken from 68 patients who all had received standard treatment for their disease and were in clinical remission for at least two years. Only 43 biopsy samples were included in the study, since the remaining 25 did not meet the study eligibility criteria.
They analyzed and compared biopsies that had been taken at the time of diagnosis to blood samples that gathered at the time they enrolled in the study and every six months thereafter.
Investigators used next-generation sequencing (NGS, a powerful DNA sequencing method) to examine the genetic profile of malignant cancer cells in the first biopsies taken from patients. Then they used NGS in patients’ recent blood samples to look for the same pattern of genetic alterations that would indicate the presence of remaining cancer cells.
Their analyses revealed that 38 of the 43 blood samples analyzed did not show any signs of remaining malignant cancer cells, suggesting that these patients potentially could be cured of their disease. For these individuals, additional treatment or active follow-up may no longer be needed for the rest of their lives.
“More important than anything perhaps, is the lifting of the psychological burden these patients faced with a diagnosis of a presumed incurable disease,” Yazdy said.
“This is a pilot study in a small number of patients with a short follow-up time. We need to do more work, study a larger number of patients, and monitor them for a longer time, but this is an important first step,” he continued.
The five remaining patients for whom NGS found signs of remaining cancer cells had been followed for a median period of 85 months (approximately seven years). These patients will continue to be monitored to see if and when they eventually will relapse.
“These data are the first to demonstrate that a high proportion of [follicular lymphoma patients] in a prolonged clinical remission have undetectable DNA by sensitive next generation sequencing, without evidence of clinical progression, and are potentially cured of their disease,” the investigators stated.
