Mercy Clinic Oncology and Hematology, Joplin, MO 64804, USA.
Curr Cancer Drug Targets. 2016;16(4):305-22. doi: 10.2174/1568009615666151030102539.
In the past 15 years, advances in molecular biology have exposed the genetic and physiopathologic heterogeneity of diffuse large B-cell lymphoma (DLBCL). Subsets of patients have been identified in which current chemoimmunotherapies may not be as efficacious, such as the activated B-cell subtype (ABC). In this review, we present an in-depth study of the differences between the two main DLBCL subsets (germinal center B cell [GCB] and ABC), focusing specifically on their different genetic features, active tumoral pathways, and pathologic features. We also discuss the bridges that have been built from the bench to the forefront of patient care through translational research, including the use of immunohistochemistry versus gene profiling to categorize patients with DLBCL and current clinical trial data pertaining to new possible targeted therapies for patients with these two subtypes of DLBCL. We hope that clinicians use this review as a tool to better understand the complexity of the two more prevalent DLBCL subtypes seen in the day to day practice and update their knowledge in both current and upcoming novel treatment options that can potentially change the outcomes of this population.
在过去的 15 年中,分子生物学的进展揭示了弥漫性大 B 细胞淋巴瘤(DLBCL)的遗传和病理生理学异质性。已经确定了一些当前化疗免疫疗法可能不太有效的患者亚组,例如激活 B 细胞亚型(ABC)。在这篇综述中,我们深入研究了两种主要的 DLBCL 亚型(生发中心 B 细胞 [GCB]和 ABC)之间的差异,特别关注它们在遗传特征、活跃肿瘤途径和病理特征方面的不同。我们还讨论了通过转化研究从实验室到患者治疗前沿架起的桥梁,包括使用免疫组织化学与基因谱分析来对 DLBCL 患者进行分类,以及目前针对这两种 DLBCL 亚型的新的可能靶向治疗的临床试验数据。我们希望临床医生将这篇综述作为一种工具,更好地理解在日常实践中更常见的两种 DLBCL 亚型的复杂性,并更新他们在当前和即将出现的潜在改变这一人群治疗结果的新型治疗方案方面的知识。