Advances in the molecular diagnosis of diffuse large B-cell lymphoma in the era of precision medicine

ABSTRACT

Introduction: The adoption of high-throughput technologies has led to a transformation in our ability to classify diffuse large B-cell lymphoma (DLBCL) into unique molecular subtypes. In parallel, the expansion of agents targeting key genetic and gene expression signatures has led to an unprecedented opportunity to personalize cancer therapies, paving the way for precision medicine.

Areas covered: This review summarizes the key molecular subtypes of DLBCL and outlines the novel technology platforms in development to discriminate clinically relevant subtypes.

Expert commentary: The application of emerging diagnostic tests into routine clinical practise is gaining momentum following the demonstration of subtype specific activity by novel agents. Co-ordinated efforts are required to ensure that these state of the art technologies provide reliable and clinically meaningful results accessible to the wider haematology community.

KEYWORDS:

• Diffuse large B-cell lymphoma (DLBCL)
• cell of origin (COO)
• precision medicine
• targeted sequencing
• MYC
• BCL2

Declaration of interest

A Davies reports the following disclosures - Roche: Advisory Boards; Honorarium; Research support, Gilead: Advisory Boards; Honorarium; Research support, Takeda: Advisory Boards; Honorarium; Research support and Travel to scientific conferences, CTI: Advisory Boards; Honorarium; Travel to scientific conferences, Mundipharma: Advisory Boards; Honorarium; Travel to scientific conferences, GSK: Research support, Bayer: Research support, Janssen: Honorarium; Research support, Karyopharma: Advisory Board; Research support, Pfizer: Research support; Honorarium. J Fitzgibbon discloses research funding: Epizyme. Honoraria: Gilead, Janssen, Celgene. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

J Fitzgibbon is supported by a Cancer Research UK (ref 15968) and Bloodwise (ref 15002) Programme Grant. S Araf is a recipient of a Cancer Research UK Clinical Research Fellowship.