Commentary on Abstracts #974 and #1297

Article

Overexpression of the bcl-2 gene can be detected in approximately 80% to 90% of patients with advanced-stage follicular NHL, as well as in 20% to 30% of those with diffuse large B-cell NHL. A number of studies have attempted to correlate outcome with residual disease using PCR in patients who have achieved a clinical complete response with chemotherapy, antibody treatment, or high-dose therapy with stem-cell support. However, the studies have been inconsistent, and, therefore, the clinical value of such measurements has been limited.

Overexpression of the bcl-2 gene can be detected in approximately 80% to 90% of patients with advanced-stage follicular NHL, as well as in 20% to 30% of those with diffuse large B-cell NHL. A number of studies have attempted to correlate outcome with residual disease using PCR in patients who have achieved a clinical complete response with chemotherapy, antibody treatment, or high-dose therapy with stem-cell support. However, the studies have been inconsistent, and, therefore, the clinical value of such measurements has been limited.

Gupta et al (abstract #974) monitored minimal residual disease using PCR in lymph node biopsies, as well as blood and bone marrow samples, from 58 patients with advanced-stage follicular NHL treated with rituximab, with follow-up evaluation of marrow and blood a month after the last infusion. Overall, 61% of patients became PCR negative, with no correlation between PCR status and clinical outcome.

Cabanillas et al (abstract #1297) reported somewhat different findings. These investigators used PCR to assess minimal residual disease in 86 previously untreated patients with stage I or II follicular NHL. Patients were treated with one of several different treatment regimens: central lymphatic irradiation, an alternating triple-therapy program, or COP (cyclophosphamide, Oncovin, and prednisone)/CHOP with or without radiation therapy.

Molecular responses were more common in patients treated with alternating triple therapy. Most cases (86%) were positive in blood before treatment. There was an apparent correlation between early response and projected failure-free survival at 7 years. Whether there is an impact on overall survival requires a longer period of observation. The discrepancies among the various studies may be explained by technique, patient selection, or other factors. Nevertheless, at present, bcl-2 assays are not a part of standard clinical practice.

Recent Videos
Linda Marbán, PhD, the CEO of Capricor Therapeutics
Matthew Wicklund, MD, a professor of neurology at the University of Texas Health Science Center San Antonio
Matthew Wicklund, MD, a professor of neurology at the University of Texas Health Science Center San Antonio
Renier Brentjens, MD, PhD, the chair of the department of medicine and the deputy director at Roswell Park Comprehensive Cancer Center
Renier Brentjens, MD, PhD, the chair of the department of medicine and the deputy director at Roswell Park Comprehensive Cancer Center
Renier Brentjens, MD, PhD, the chair of the department of medicine and the deputy director at Roswell Park Comprehensive Cancer Center
Renier Brentjens, MD, PhD, the chair of the department of medicine and the deputy director at Roswell Park Comprehensive Cancer Center
David-Alexandre C. Gros, MD, Eledon’s chief executive officer
Robert Califf, MD, MACC, a cardiologist and former FDA commissioner
Natalie Goedeker, CPNP, on Handling Neuromuscular Gene Therapy at Real-World Sites
© 2025 MJH Life Sciences

All rights reserved.