Frontiers in Oncology (Feb 2020)

Comprehensive Molecular Profiling for Relapsed/Refractory Pediatric Burkitt Lymphomas—Retrospective Analysis of Three Real-Life Clinical Cases—Addressing Issues on Randomization and Customization at the Bedside

  • Kristyna Polaskova,
  • Kristyna Polaskova,
  • Tomas Merta,
  • Tomas Merta,
  • Alexandra Martincekova,
  • Alexandra Martincekova,
  • Danica Zapletalova,
  • Danica Zapletalova,
  • Michal Kyr,
  • Michal Kyr,
  • Pavel Mazanek,
  • Zdenka Krenova,
  • Peter Mudry,
  • Marta Jezova,
  • Jiri Tuma,
  • Jarmila Skotakova,
  • Ivana Cervinkova,
  • Dalibor Valik,
  • Dalibor Valik,
  • Lenka Zdrazilova-Dubska,
  • Lenka Zdrazilova-Dubska,
  • Hana Noskova,
  • Karol Pal,
  • Ondrej Slaby,
  • Pavel Fabian,
  • Sarka Kozakova,
  • Sarka Kozakova,
  • Jakub Neradil,
  • Jakub Neradil,
  • Renata Veselska,
  • Renata Veselska,
  • Veronika Kanderova,
  • Ondrej Hrusak,
  • Tomas Freiberger,
  • Tomas Freiberger,
  • Tomas Freiberger,
  • Giannoula Lakka Klement,
  • Giannoula Lakka Klement,
  • Jaroslav Sterba,
  • Jaroslav Sterba,
  • Jaroslav Sterba

DOI
https://doi.org/10.3389/fonc.2019.01531
Journal volume & issue
Vol. 9

Abstract

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In order to identify reasons for treatment failures when using targeted therapies, we have analyzed the comprehensive molecular profiles of three relapsed, poor-prognosis Burkitt lymphoma cases. All three cases had resembling clinical presentation and histology and all three patients relapsed, but their outcomes differed significantly. The samples of their tumor tissue were analyzed using whole-exome sequencing, gene expression profiling, phosphoproteomic assays, and single-cell phosphoflow cytometry. These results explain different treatment responses of the three histologically identical but molecularly different tumors. Our findings support a personalized approach for patient with high risk, refractory, and rare diseases and may contribute to personalized and customized treatment efforts for patients with limited treatment options like relapsed/refractory Burkitt lymphoma.SummaryThe main aim of this study is to analyze three relapsed Burkitt lymphoma patients using a comprehensive molecular profiling, in order to explain their different outcomes and to propose a biomarker-based targeted treatment. In cases 1 and 3, the tumor tissue and the host were analyzed prospectively and appropriate target for the treatment was successfully implemented; however, in case 2, analyses become available only retrospectively and his empirically based rescue treatment did not hit the right target of his disease.

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