[Malignant lymphomas - quo vadis? - What developments await us in diagnostics and therapy?]

The diagnosis and treatment of malignant lymphoma is rapidly advancing, offering hope but also highlighting inherent limitations. Technological breakthroughs in sequencing technologies enable more precise subtyping and risk stratification. For example, in diffuse large B-cell lymphoma (DLBCL), exome sequencing revealed molecular subtypes. Understanding these subtypes sheds light on lymphomagenesis and prognosis, and may provide targets for tailored therapies. Additionally, tumor-derived cell-free DNA (ctDNA) detected in blood plasma allows for genotyping, risk stratification, and measurement of minimal residual disease (MRD). Current studies often examine drug effectiveness through "all-comer" approaches or in transcriptionally defined subtypes. Molecular agnostic studies increasingly focus on clinically defined high-risk patients (e.g., using the IPI) to better demonstrate the statistical significance of therapy effects. Improved patient selection can enhance the cost-effectiveness of modern, often expensive, therapies.
Competing Interests: SKA: Honoraria – Takeda Pharmaceuticals CP: Research support – Morphosys, Roche; Honoraria – Roche, Novartis, Gilead Janssen, Incyte, Abbvie, BMS, Astra Zencea, Lilly BC: Research support – Gilead Sciences Honoraria – Talks: AbbVie, Ars tempi, Astra Zeneca, BMS, Incyte, Janssen, Gilead, KML, Roche, Sandoz, Sobi, Ono; Advisory boards – AbbVie, BMS, Incyte, Janssen, Gilead, Regeneron, Roche, Sobi Patents on molecular subtyping of large B-cell lymphoma
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