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Everything in development, the medicines held by this cancer's subtypes, the open problems and what is being done about them, the roadmaps, and what changed on this record.
What is in development for Gastric MALT lymphoma, drawn from the whole corpus: 0 items. Drugs are grouped by the most advanced trial phase they have reached anywhere; approved treatments sit under standard of care. Technologies are the methods being tested for this cancer, trials are the studies recorded here, and ideas are proposals not yet in a trial.
Nothing recorded in development for this cancer yet.
Helicobacter pylori resistance to clarithromycin is rising in many countries, and the first treatment for this lymphoma is an antibiotic regimen that is becoming less reliable.
There is no agreed definition of how long to watch residual lymphoma on biopsy before treating it, and the evidence that watching is safe comes from one prospective series.
Nobody knows why a minority of Helicobacter pylori-negative gastric MALT lymphomas respond to eradication therapy anyway.
Dated changes read from the records linked to this cancer: approvals, regulatory steps, reported trials, guideline versions and milestones. Newest first; no date is inferred.
On EdgeAll 7 changes by month →When this page itself was last checked or edited.
Endoscopy with multiple biopsies from the abnormal area and from every region of the stomach, because the lymphoma is patchy and a single biopsy can miss it. Helicobacter pylori is sought by more than one method. Endoscopic ultrasound measures how deep the lymphoma goes, which predicts whether antibiotics alone will work; in a prospective comparison against the resected stomach it judged the depth correctly in 91.5 per cent of cases. Fluorescence in situ hybridisation for t(11;18) is done where it will change the plan. Staging uses the gastrointestinal system that counts depth and node involvement rather than the ordinary node-region count.
WHO-HAEM5 sets out that BIRC3::MALT1 from t(11;18) is recurrent in gastric and pulmonary disease and rare at other sites, and that it identifies the gastric cases that will not respond to eradication.
A standard eradication regimen of a proton pump inhibitor with two antibiotics, chosen by local resistance patterns, is the first treatment for Helicobacter pylori-positive disease and is also offered in negative disease, where a minority still respond. Success is confirmed by a breath or stool test after treatment, and the lymphoma is then followed by repeated endoscopy and biopsy over months, because regression is slow. In the prospective series of 120 patients with stage I disease, 80 per cent achieved complete histological remission and 80 per cent of those remained in continuous remission at a median follow-up of 75 months.
Residual lymphoma on a biopsy after successful eradication is common and usually does not need treatment. In the same series, 17 per cent of those who had reached complete remission later showed histological residual disease; they were watched rather than treated, and all of them entered a second remission. A persisting monoclonal band in the immunoglobulin genes is also common and is not by itself a reason to treat. What does need action is growth, new symptoms, or large cells appearing on the biopsy.
In 120 patients with stage I disease followed for a median of 75 months, 80 per cent reached complete histological remission, 80 per cent of those stayed in it, five-year survival was 90 per cent, and 15 per cent of lymphomas carried t(11;18), which predicted failure to respond.