Mediastinal B Cell Lymphoma

In PMBCL, the Children's Oncology Group (COG) and the National Cancer Institute (NCI) National Clinical Trials Network (NCTN) recently completed a randomized phase III trial of nivolumab in combination with chemo-immunotherapy in children and adults with newly diagnosed PMBCL...In ALCL and ANKL, ongoing clinical trials are evaluating the efficacy of ICT. Given the transformational role of ICT for pediatric Hodgkin lymphoma, there is significant promise for the use of ICT in multiple subtypes of pediatric non-Hodgkin lymphoma with increased expression of PD-L1.

P1/2, N=32, Active, not recruiting, Ospedale Pediatrico Bambino Gesu | Recruiting --> Active, not recruiting

Comparative analysis with PMBL highlighted shared oncogenic programs and key distinctions: HRS cells exhibited greater loss of B cell identity, absence of GCB- and plasma cell markers, and unique upregulation of cytoskeletal and mitotic pathways consistent with their multinucleated morphology. These findings establish HRS cells as aberrantly differentiated GCB cells with partial plasmacytic features, UPR activation and distinct immune evasion strategies.

P=N/A, N=100, Not yet recruiting, Fondazione Italiana Linfomi - ETS

P2, N=30, Active, not recruiting, David Bond, MD | Trial completion date: Dec 2025 --> Dec 2026

Immune-based therapies, including brentuximab vedotin and PD-1 inhibitors, have shown promising activity, particularly in combination. MGZL remains a diagnostically challenging and therapeutically complex lymphoma with inferior outcomes compared with related mediastinal lymphomas. Advances in molecular profiling and immunotherapy offer promising avenues toward more personalized treatment; however, prospective clinical trials and international collaboration are urgently needed to establish evidence-based management strategies for this rare entity.

So, it seems possible to characterize localized single cells in tissues using hybridization and sequencing technologies to provide further information of cell-cell interactions and the resulting molecular changes by bioinformatics.These developments open new perspectives for personalised medicine and could help to better predict the success of innovative cell therapies. This article was created to accompany the 62nd IAP Symposium, "Lymph Nodes and Lymphoma Pathology-The Essentials."

P1/2, N=32, Active, not recruiting, Bambino Gesù Hospital and Research Institute | Recruiting --> Active, not recruiting | Trial primary completion date: Mar 2025 --> Mar 2027

the obtained results suggest that the immune checkpoints in PMBCL cells are affected by both their genetic profile and tumour microenvironment.

First-line management for LBCL can be informed by interim PET to assess chemosensitivity, with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) or polatuzumab vedotin rituximab, cyclophosphamide, doxorubicin, and prednisone (Pola-R-CHP) for advanced stages depending on IPI scores. Primary mediastinal B-cell lymphoma (PMBCL) management favors R-CHOP given every 14 days (R-CHOP14) or dose-adjusted etoposide, doxorubicin, vincristine, cyclophosphamide, prednisone, and rituximab (DA-EPOCH-R) without radiotherapy in complete responders...CART in CART-naïve patients and bispecific antibodies appear to be the best approach in 3L. Follow-up includes clinical examination for 2 years and management for long-term side effects, such as cardiotoxicity, osteoporosis, immune dysfunction, neurocognitive impairment, endocrine dysfunction, fatigue, neuropathy, and mental distress.

P2, N=25, Recruiting, New York Medical College | Trial completion date: Dec 2024 --> Dec 2027 | Trial primary completion date: Dec 2024 --> Dec 2026

Vena cava superior syndrome is caused in over 60% of the cases by malignancies (bronchogenic carcinoma, lymphoma, germ cell tumour).Facial swelling, plethora of the upper chest without itchiness and hoarseness are classical symptoms of thoracic central venous obstruction.At every patient visit open-minded clinical reasoning should be used to avoid anchoring bias.