Methods for treatment of lymphomas with mutations in cell cycle genes
The present disclosure identifies a novel subtype of follicular lymphoma (FL) characterized by dysregulation of the cyclin/CDK/RB proliferative pathway. This subtype of FL is associated with increased malignancy and mortality, relative to FL which is not associated with cell cycle dysregulation. Accordingly, this disclosure presents novel methods to subtype FL and stratify patient risk by detection of biomarkers associated with RB inactivation. This disclosure further presents novel therapies for the treatment of FL subtyped by inactivation of RB.
1. A pharmaceutical composition for treating follicular lymphoma, comprising a combination of a sub-optimal dose of a B-cell lymphoma-2 (BCL2) inhibitor selected from ABT-737 or Obatoclax mesvlate, and a sub-optimal dose of the cyclin-dependent kinase (CDK) inhibitor PD-0332991, wherein the combination is effective for the treatment of a patient identified as having retinoblastoma (RB)-inactivated FL.
2. A method of treating follicular lymphoma (FL) in a patient identified as having retinoblastoma (RB)-inactivated FL, comprising administering a combination of a sub-optimal dose of a B-cell lymphoma-2 (BCL2) inhibitor selected from ABT-737 or Obatoclax mesylate, and a sub-optimal dose of the cyclin-dependent kinase (CDK)4/6 inhibitor PD-0332991, in an amount effective to treat RB-inactivated FL in said patient.
3. The method of claim 2 , wherein the patient has been identified as having retinoblastoma (RB)-inactivated FL by detecting a biomarker associated with inactivation of the retinoblastoma (RB) protein in a sample from said patient.
4. The method of claim 3 , wherein said biomarker is selected from one or more of the group consisting of phosphorylated RB protein, increased level or activity of cyclin-dependent kinase (CDK)4, increased level or activity of Cyclin D3, and decreased level or activity of p16.
5. The method of claim 3 , wherein said biomarker is a genetic alteration in one or more of the Rb locus, the CDK4 locus, the Cyclin D3 locus, or the CDKN2A/B locus.
6. A pharmaceutical composition for treating follicular lymphoma, comprising a combination of a B-cell lymphoma-2 (BCL2) inhibitor selected from ABT-737 or Obatoclax mesylate, and the cyclin-dependent kinase (CDK) inhibitor PD-0332991, wherein the combination is effective for the treatment of a patient identified as having retinoblastoma (RB)-inactivated FL.
7. A method of treating follicular lymphoma (FL) in a patient identified as having retinoblastoma (RB)-inactivated FL, comprising administering a combination of a B-cell lymphoma-2 (BCL2) inhibitor selected from ABT-737 or Obatoclax mesylate, and the cyclin-dependent kinase (CDK)4/6 inhibitor PD-0332991, in an amount effective to treat RB-inactivated FL in said patient.
8. The method of claim 7 , wherein the patient has been identified as having retinoblastoma (RB)-inactivated FL by detecting a biomarker associated with inactivation of the retinoblastoma (RB) protein in a sample from said patient.
9. The method of claim 8 , wherein said biomarker is selected from one or more of the group consisting of phosphorylated RB protein, increased level or activity of cyclin-dependent kinase (CDK)4, increased level or activity of Cyclin D3, and decreased level or activity of p16.
10. The method of claim 8 , wherein said biomarker is a genetic alteration in one or more of the Rb locus, the CDK4 locus, the Cyclin D3 locus, or the CDKN2A/B locus.