Emerging Treatment Options for Adolescents and Young Adults with Relapsed or Refractory Lymphoma

Lymphomas are amongst the most common cancers in Adolescents and Young Adults (AYA). Despite favorable outcomes with upfront therapy, survival in patients with relapsed or refractory disease remains poor. Promising therapeutic agents are emerging, including monoclonal antibodies, antibody drug conjugates, immune checkpoint inhibitors, cytotoxic T-cell therapies, small molecule pathway inhibitors and epigenetic modulators. Clinical trials of novel agents have predominantly enrolled older adult patients. Furthermore, research relating to the biology of lymphomas has focused predominately on younger children and older adults. Future investigation should concentrate on the biology of lymphomas in AYAs and improving their participation in clinical trials. Nmazuo W. Ozuah1 and Ann S. LaCasce2* 1Department of Pediatric Oncology, Dana Farber Cancer Institute, USA 2Department of Medical Oncology, Dana Farber Cancer Institute, USA Ann S. LaCasce, et al., Clinics in Oncology Radiological Techniques and Scans Remedy Publications LLC., | http://clinicsinoncology.com/ 2016 | Volume 1 | Article 1141 2 In recent years our understanding of lymphoma biology and the pathways that drive oncogenesis has evolved, leading to opportunities to explore novel targeted therapies. Some of these pathways and their targets are illustrated in Figure 1. Unfortunately, studying the biology of lymphomas in AYAs has not kept pace with our understanding of the disease in children and older adults. Hence, strategies for treating this population have not been clearly defined [2]. These novel agents have been tested in clinical trials, typically in older adult populations. We recognize that the young adults are underrepresented in many trials; particularly the B-NHL studies and differences in biology across age groups, likely inform treatment responses. Nonetheless, we feel the results of these studies may warrant extrapolation to adolescent and young adult populations.