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Everything in development, the medicines held by this cancer's subtypes, the open problems and what is being done about them, the roadmaps, and what changed on this record.
What is in development for Non-Hodgkin lymphoma (all types), drawn from the whole corpus: 157 items. Drugs are grouped by the most advanced trial phase they have reached anywhere; approved treatments sit under standard of care. Technologies are the methods being tested for this cancer, trials are the studies recorded here, and ideas are proposals not yet in a trial.
109 medicines on record are linked to one of the types below rather than to Non-Hodgkin lymphoma (all types) itself. Grouped by the type that holds them; each list opens that type's own page.
Relapsed T-cell lymphomas still lack effective options.
Background: Circulating tumour DNA (ctDNA), Minimal / molecular residual disease (MRD). Also on OnCo: Treatment journeys · Survivorship planner.
Access to CAR-T and bispecifics outside high-income countries.
Also on OnCo: Financial help · Coverage by country · Funding verdicts by country.
The genetic classifications of large B-cell lymphoma are the best-validated molecular taxonomy in haematology and no randomised trial has yet assigned treatment by one. Patients are genotyped, told which subtype they have, and then given the same regimen as everyone else.
Also on OnCo: Find a trial · Expert centres.
Cell of origin has been known for a quarter of a century and every randomised attempt to act on it in first line has failed to change survival in the whole population. It is not clear whether the problem is the classification, the drugs chosen, or the fact that immunohistochemistry cannot separate the activated type from the unclassified one.
Nobody knows how often a large B-cell lymphoma relapses without CD19 after CAR-T. The published series are small and do not agree, and most relapses are not rebiopsied at all, so the field is choosing second treatments without the measurement that would decide between them.
Background: Circulating tumour DNA (ctDNA), Minimal / molecular residual disease (MRD). Also on OnCo: Treatment journeys · Survivorship planner.
The same is true of CD20: the only series that looked found 5 of 19 rebiopsied relapses had lost the antigen, which means the denominator for every other patient is unknown and a second anti-CD20 drug is often given without checking the target is still there.
Background: Circulating tumour DNA (ctDNA), Minimal / molecular residual disease (MRD). Also on OnCo: Treatment journeys · Survivorship planner.
MYC has been a known driver of Burkitt lymphoma since 1982 and there is still no drug that acts on it. The regimens that cure Burkitt lymphoma are the most toxic in lymphoma, which is why it remains hardest to treat in older patients and in the equatorial regions where the endemic form occurs.
Circulating tumour DNA in lymphoma can genotype, measure burden and find residual disease at parts per million, and no trial has yet shown that changing treatment on the result helps anyone.
Background: Circulating tumour DNA (ctDNA), Minimal / molecular residual disease (MRD). Also on OnCo: Treatment journeys · Survivorship planner.
BCL2 was the first apoptosis gene found in a human cancer and venetoclax has not repeated its chronic lymphocytic leukaemia result in follicular or large B-cell lymphoma, because those cells also lean on MCL1 and BCL-xL. MCL1 inhibitors have been held back by cardiac toxicity.
Background: Quality of life. Also on OnCo: Side effects by symptom · Checkpoint side effects by organ · Side effect rates across a drug class · Survivorship planner.
The T-cell and NK-cell lymphomas are about one lymphoma in twenty and have a small fraction of the trials, the drugs and the survival gains of the B-cell lymphomas. Five-year relative survival in the UK population series was 45.4 per cent across T-cell lymphomas against 68.8 per cent across B-cell lymphomas.
Several of these diseases are common where trials are not run. Extranodal NK/T-cell lymphoma is a disease of east Asia and Latin America; adult T-cell leukaemia/lymphoma is a disease of south-western Japan, the Caribbean and west Africa. The treatments with the best evidence were developed there, and are least available to people from those populations living elsewhere.
Two reference classifications were published in 2022 and they disagree about names and boundaries. A patient can be told they have three different diagnoses depending on which book the pathologist used and which trial they are being screened for.
CAR-T and bispecific antibodies are available in a small number of countries and in a small number of centres within them. The gap between what is possible and what is reachable is now the main determinant of outcome in relapsed large B-cell lymphoma.
Background: Circulating tumour DNA (ctDNA), Minimal / molecular residual disease (MRD). Also on OnCo: Treatment journeys · Survivorship planner.
There is no way to predict which indolent lymphoma will transform into an aggressive one, and transformation is the commonest cause of death in follicular lymphoma.
Three genetic classifications of diffuse large B-cell lymphoma exist and none of them decides anyone's first-line treatment outside a trial. The gap between Schmitz in 2018 and a randomised trial that assigns treatment by LymphGen subtype is the clearest unfinished business in the disease.
Circulating tumour DNA predicts outcome at diagnosis, detects residual disease better than imaging and flags transformation before it declares itself, and no randomised trial has yet shown that changing treatment on the strength of it helps anyone.
Background: Circulating tumour DNA (ctDNA), Minimal / molecular residual disease (MRD). Also on OnCo: Treatment journeys · Survivorship planner.
The T-cell lymphomas have almost no randomised evidence. Adult T-cell leukaemia/lymphoma has had exactly one controlled trial, opened in 1998 with 118 patients, and the regimen that makes extranodal NK/T-cell lymphoma treatable rests on a 38-patient single-arm study.
Also on OnCo: Find a trial · Expert centres.
Rituximab is thirty years old and still unavailable or unaffordable in much of the world, asparaginase is subject to recurrent shortages, and CAR-T needs an apheresis service and a cryopreservation chain. Lymphoma is among the most curable common cancers in the places that have the drugs.
Also on OnCo: Financial help · Coverage by country · Funding verdicts by country.
Dated changes read from the records linked to this cancer: approvals, regulatory steps, reported trials, guideline versions and milestones. Newest first; no date is inferred.
On EdgeAll 102 changes by month →When this page itself was last checked or edited.
First-line advanced classical Hodgkin lymphoma with AVD, age ≥12 (SWOG S1826)
Untreated advanced classical Hodgkin lymphoma with AVD, age ≥12
Three-year progression-free survival 78 percent after high-dose chemotherapy and autologous transplant against 51 percent after non-myeloablative R-DeVIC (hazard ratio 0.
Median overall survival 19.
Median investigator-assessed progression-free survival 22.