Advances in Lymphoma
Transcript: Congress themes and overlooked data
Professor Wojciech Jurczak
All transcripts are created from interview footage and directly reflect the content of the interview at the time. The content is that of the speaker and is not adjusted by Medthority.
The biggest upgrade on both ASCO and EHA Conference is the building evidence that the old and traditional standard of care is standard of the past. Even more, we will not have, possibly ever, the standard of care like A followed by B followed by C.
We are living in a world where there will always be more than one possibility to get the patients through, and in fact, we will have to choose the adequate treatment combination, adequate for the patient. So in a way, it may be called individualized-patients therapy but will be individualised not just for the disease but also for the comorbidities and the patient's general status. And it's particularly a good message for all elderly and comorbid individuals as adverse events of the modern drugs are different and they will allow for a much better way the elderly population could be treated. There is also another revolution, which is ongoing but not yet done. In indolent lymphomas, we tend to say that we may postpone therapy until we have a tumour burden which is important enough or symptoms which are bothering the patients. Watch and wait is still a standard of care; however, you know that, by watch and wait, we certainly have the evolution of clones and, at the end of the day, the disease which is more difficult to treat; therefore, if we could only prove that any of our treatment modalities will cause a cure to low-grade-lymphoma patients, then our policy will change automatically and we will like to treat the patients on as-fast-as-possible basis; therefore, there were emerging studies demonstrating the role of biospecific monoclonals in the first line, both in follicular lymphoma and in diffuse large B cell lymphoma. Very interesting results, very integrating, and in diffuse large B cell lymphoma, they might change the prognosis by increasing the response rate to the first line of therapy, which is always most important, while, in follicular lymphoma, they may make a revolutionary change of getting away of wait-and-see altogether. But we are not yet there.
We are waiting for it, observing the trial results. And there was one fancy study presented in a late abstract session on EHA, the study not on lymphomas. In this study, sets of patients with myeloid malignancies and cytopenias were randomised to those who were substituted with vitamin C and substituted with a placebo. As the authors raised, over 60% of patients have the vitamin C deficiency. It was a small group, 100 patients randomised, with a long observation, and quite astonishingly, it occurred that the overall survival curves were statistically different, and the patients who received vitamin C, and we're not talking about copious dosages, just supplementing the deficiency, were doing better.
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