Researchers at Stanford University School of Medicine and Applied Biosystems have identified six genes that may help physicians determine whether a patient with diffuse large-B-cell lymphoma will respond to treatment.
Findings from the study, which relied on ABI’s RT-PCR technology, may lead to one of the first molecular diagnostics that identifies individuals who may need aggressive therapy to treat their lymphoma.
The results have led ABI to file for a patent that would cover the probes and primers used in the research, and may enable reference labs to perform tests on patients with lymphoma.
Individuals diagnosed with the disease are generally prescribed a treatment regimen after physicians perform the International Prognostic Index, a standard protocol. However, two patients with identical scores often react differently to the same therapy.
“It makes a big difference in your treatment decisions if you think you have a high chance of success or if you don’t,” said Ronald Levy, a professor of medicine at Stanford, and study leader. “New therapies are usually tested in people who have failed the standard therapy. If you know in advance who won’t respond well, you can treat them more aggressively or include these patients in trials of the many promising, new targeted therapies.”
To arrive at their results, Levy and colleagues developed an RT-PCR screen with ABI that monitored the expression of 36 genes most commonly linked with large-B-cell lymphoma against 66 tumor samples obtained from lymphoma patients treated at Stanford.
The researchers next tested the predictive ability of six of the 36 genes in patients who participated in two earlier traditional microarray studies at Stanford. These genes again were “distinguished between patients who responded well to treatment and those who did not.” The study appears in the April 29 New England Journal of Medicine.
In a statement, Levy said the RT-PCR-based test is “more likely to become widely used” if it can be easily incorporated into medical labs, and added that physicians would “likely” combine information from their traditional classification protocols with results from the six-gene screen “to decide how best to treat the patient.”
Izidore Lossos, an associate professor of clinical medicine at the University of Miami/Jackson Memorial Medical Center and the first author on the paper, said he does not know “their intention to produce a test,” but stressed that “every laboratory can do this” because the study provides sequence data for the primers and probes they’d need, as well as what steps they need to take to perform the reaction. He said reference pathology labs that would want to perform these tests will need to buy the primers and probes from ABI.