Grant: CIHR Fellowship

BACKGROUND: Non-Hodgkin's lymphoma is the 6th leading cause of cancer-related death in Canada, and follicular lymphoma (FL) is one of its most common types. Although considered incurable, tumours in 15% of untreated FL patients undergo spontaneous regression, and recent studies suggest a link between the host immune response and disease progression. Specifically, several groups have shown that the presence of T cells in FL tumours at diagnosis correlates with increased patient survival. PROJECT DESCRIPTION: In order to develop an effective immune-based treatment strategy for FL, I propose to assess the immune response to cancer in FL patients. My hypothesis is that specific T cells (so-called "killer" T cells) are responsible for increased survival in FL patients and that chemotherapy helps to enhance this response. In collaboration with BC Cancer Agency medical oncologists and pathologists, I will first obtain tumour samples from FL patients and define the T cell subsets present in different patients. I will then obtain blood samples from patients before and after chemotherapy and compare their T cell responses to the responses of patients who choose to undergo "watchful-waiting" instead of chemotherapy. I expect that treated patients will demonstrate increased anti-tumour T cell responses. This information could be used for designing a T cell based treatment strategy for patients who do not themselves mount an adequate anti-tumour response. CLINICAL RELEVANCE: Innovative, effective treatments for FL are desperately needed. Personalized immune-based therapies, such as the T cell therapy that I am proposing, have considerable promise for treating FL and other cancers for which current treatments are inadequate. Thus, defining the T cell subsets that are naturally associated with increased survival in FL patients will lay the foundation for the clinical immunotherapy program under development at our centre.