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29-12-2016 | Lymphoma | Article

The landscape of new drugs in lymphoma

Authors: Anas Younes, Stephen Ansell, Nathan Fowler, Wyndham Wilson, Sven de Vos, John Seymour, Ranjana Advani, Andres Forero, Frank Morschhauser, Marie Jose Kersten, Kensei Tobinai, Pier Luigi Zinzani, Emanuele Zucca, Jeremy Abramson, Julie Vose

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Abstract

The landscape of drugs for the treatment of lymphoma has become crowded in light of the plethora of new agents, necessitating the efficient prioritization of drugs for expedited development. The number of drugs available, and the fact that many can be given for an extended period of time, has resulted in the emergence of new challenges; these include determining the optimal duration of therapy, and the need to balance costs, benefits, and the risk of late-onset toxicities. Moreover, with the increase in the number of available investigational drugs, the number of possible combinations is becoming overwhelming, which necessitates prioritization plans for the selective development of novel combination regimens. In this Review, we describe the most-promising agents in clinical development for the treatment of lymphoma, and provide expert opinion on new strategies that might enable more streamlined drug development. We also address new approaches for patient selection and for incorporating new end points into clinical trials.

Nat Rev Clin Oncol 2017; 14: 335–346. doi:10.1038/nrclinonc.2016.205

Subject terms: Cancer immunotherapy • Clinical trials • Combination drug therapy • Lymphoma • Targeted therapies

Hundreds of new agents are currently being evaluated in preclinical and clinical settings for the treatment of cancer, and the failure rate of drug development processes remains very high1. The majority of agents are not successful owing to unacceptable toxicities and/or a lack of antitumour efficacy. Biomarkers to enable selection of patients for a specific therapy and the development of mechanism-based combination regimens are among the strategies that are being deployed to improve the success of drug development. However, drug development, unfortunately, remains a lengthy process that delays the availability of potentially life-saving new drugs. To help overcome these obstacles, innovative clinical trial designs that incorporate robust clinical end points and informative biomarkers are needed.

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