Immunotherapy trials aim to improve treatments for patients with an aggressive form of blood cancer

Two new immunotherapy clinical trials for people with an aggressive form of lymphoma are being launched by researchers in Southampton.

It’s hoped the Pola-RICE and P+R-ICE studies can improve survival and quality of life for patients with diffuse large B cell lymphoma (DLBCL) where the cancer has come back or is resistant to current treatment.

The trials are both led by Professor Andy Davies, Professor of Haematological Oncology at the University of Southampton, and are being run by the Southampton Clinical Trials Unit based at the University’s Centre for Cancer Immunology.

A need for new treatments

DLBCL is a type of non-Hodgkin lymphoma where white blood cells, called B lymphocytes, begin to grow abnormally and cannot do their usual job of fighting infections in the body. Around 5,500 people are diagnosed with diffuse large B cell lymphoma (DLBCL) each year in the UK and will begin treatment.

“In around a third of patients, this first-line treatment will be unsuccessful,” says Professor Davies. “The lymphoma either does not respond or returns after initial slowing of the disease, and in these cases, patients will need to start a second-line therapy.”

One of the second-line treatments currently used is a combination of chemotherapy and immunotherapy drugs called R-ICE followed by a stem cell transplant.

Professor Davies continues: “Unfortunately, around half of patients will still not respond to these treatments and we therefore need to look at additional approaches that can target this aggressive form of cancer and really benefit these patients.”

Boosting the immune system against DLBCL

Both these new trials are looking at whether adding an additional immunotherapy treatment can improve R-ICE therapy for DLBCL patients. Immunotherapies work by boosting the patient’s own immune system to help it find and destroy the cancer.

The P+R-ICE study involves pembrolizumab, a type of drug called a checkpoint inhibitor.

These drugs block a protein on the surface of immune cells which causes the cells to be switched off, and which can be used by cancer cells to stop the immune system from working properly. By blocking this protein, the T cell is thereby stimulated into action and can seek out and destroy cancer cells.

Amber Cole, Trial Manager from P+R-ICE at the Southampton Clinical Trials Unit, says “Pembrolizumab is already used as a treatment for some other cancers such as melanoma and bladder cancer, as well as for Hodgkin lymphoma. Through the P+R-ICE trial we want to see whether it can also be an effective therapy to help improve outcomes for those with DLBCL as well.”

65 people will be recruited into the trial and will be randomly allocated into one of two trial arms. Two thirds will receive the R-ICE plus pembrolizumab, while those in the other arm will remain on R-ICE standard treatment.  The trial opened to recruitment in July and has already recruited its first patients.