The DIRECT study is a molecular profiling study for patients with diffuse large B cell lymphoma (DLBCL) and closely related aggressive lymphomas. DLBCL is the commonest haematological malignancy with over 4,500 cases annually in the UK. Patients with DLBCL will be recruited from Addenbrooke’s Hospital and four other UK teaching hospitals. The Cancer Molecular Diagnostics Lab (CMDL), which is located in the Clifford Allbutt Building, will collect tissue biopsies and blood samples from each patient for genomic analysis.
Daniel Hodson (Haematology and Wellcome-MRC Cambridge Stem Cell Institute), Chief Investigator for the trial and member of the CRUK Cambridge Centre Haematological Malignancies Programme, will bring together the data from all patients enrolled on the study to develop an integrated pipeline based upon genomic profiling of the diagnostic sample, molecular response assessment by serial circulating tumour DNA analysis and functional imaging. This will be used to predict, for each patient, the probability of successful treatment with standard immunochemotherapy regimens. Patients identified as being at high risk of failing standard therapy will, in future trials, be prioritised for experimental therapies.
The trial is jointly funded by AstraZeneca and the Cancer Research UK Cambridge Centre and is one of the flagship trials for the Mark Foundation Institute for Integrated Cancer Medicine which aims to integrate real-time patient data from multiple sources to inform and predict the best treatment decisions for individual patients.