Blood cancers, including leukemias, lymphomas, and myelomas, are a leading cause of cancer-related death in the United States. Non-Hodgkin's lymphomas (NHL) are the 5th most common type of cancer, and among patients with NHL, those with follicular lymphoma (FL) comprise a large fraction, and include veterans, military affiliates and their families. While outcomes for these patients have improved with new therapies, FL remains an incurable disease. We propose to develop a new way to predict which of these patients respond very well to current and emerging treatments and which do not. To do this we will use new technologies of genetic analysis of the patient and of their tumors. Once we can accurately make these predictions, we will know who may be offered new forms of treatment that are being developed by us and by others working on this disease.

To improve outcomes for blood cancer patients, I hope to become a research professor in cancer biology and to start a laboratory focusing on fundamental problems in the blood cancer field. The overarching goal of my research group will be to apply state-of-the-art technologies to examine how patients and individual tumors differ from one another in terms of disease presentation, progression, response to therapy, and survival. In so doing, I hope to discover important differences between patients that will allow us to improve the safety and effectiveness of clinical trials, to improve cancer detection strategies, and to identify better cancer therapies. With assistance from my mentor, I have developed a training program that will help me to achieve these career goals by strengthening my background in relevant academic fields, growing my network of contacts and potential collaborators, further developing essential laboratory skills, and enhancing scientific leadership skills through student mentorship. The proposed research plan, described above, will require the development of new methods to help identify which patients will benefit from new cancer treatments and which will not, and is thus directly related to my career goals. The proposed research will impact the FY11 PRCRP Topic Area, Blood Cancers and, if successful, will improve our ability to discriminate between responding and non-responding patients in the short term, which should ultimately increase the success rate of clinical trials testing novel FL treatments. In the long term, this research, if successful, will lead to a greater diversity of treatment options tailored to the unique characteristics of individual FL patients, and will thus advance PRCRP's vision of reducing the impact of blood cancers on military beneficiaries and the general American public. Moreover, in the future, the new methods arising from this project could be applied to additional cancers, including all types of NHL and other blood cancers. The projected time to achieve patient-related outcomes will be on the order of typical clinical trials. However, the methods developed will be applicable to trials currently underway, potentially offering rapid patient benefits. FL, like many cancers, is a highly heterogeneous disease, making it extremely difficult, and perhaps infeasible, to develop a "one size-fits-all" treatment. This study, if successful, will provide important new strategies to improve the lives of civilians, military beneficiaries, and their families, struggling with this devastating disease.