Genome and transcriptome profiling informs findings in relapsed lymphoma cohort

A multicentre precision-oncology cohort assessed whole-genome and transcriptome analysis in 65 patients with relapsed or refractory non-Hodgkin lymphoma. Testing produced potentially useful findings for most patients, but changed management in 15%; access to targeted drugs and timing of testing limited implementation.

WGTA produced potentially useful findings in 89% of patients.
Management changed in 15% of the 65-patient cohort.
Testing identified five transcriptome-based biological subgroups.
Access and timing limited clinical implementation.

Researchers evaluated whole-genome and transcriptome analysis (WGTA) in 65 patients with relapsed or refractory non-Hodgkin lymphoma enrolled in Canadian precision-oncology initiatives. The cohort included 37 children, 14 adolescents and young adults, and 14 adults. The analysis examined the clinical utility of profiling, including its potential to guide treatment and clarify disease biology.

WGTA yielded findings considered potentially useful in 89% of patients, including information for therapy selection, diagnostic clarification, resistance prediction, minimal residual disease marker identification, and detection of germline cancer predisposition. Results altered management in 15%. Transcriptome-based clustering identified five biological subgroups, while mutational signatures showed hypermutation patterns consistent with genomic damage associated with prior cytotoxic therapy.

The findings indicate potential uses for comprehensive profiling in relapsed or refractory lymphoma, but they do not establish improved patient outcomes. Implementation was constrained by clinical deterioration, availability of standard treatments, and limited access to targeted agents. The abstract does not provide details on specific treatments selected or outcomes following profiling.

In practice

For patients with relapsed or refractory non-Hodgkin lymphoma, comprehensive genome and transcriptome profiling may identify treatment-relevant findings, clarify diagnosis, or reveal resistance and disease markers. In this 65-patient cohort, findings were considered potentially useful in 89%, but management changed in 15%. These results support potential clinical utility, not a demonstrated improvement in outcomes or a mandate to change testing practice. Clinical uptake was limited by patient deterioration, standard-treatment availability, and access to targeted agents.

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Source

British Journal of Haematology: Whole‐genome and transcriptome analysis in relapsed/refractory non‐Hodgkin lymphoma: Results from a multicentre precision oncology cohort ↗

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