Andrew L. Feldman, M.D.

Andrew L. Feldman, M.D., studies the molecular pathogenesis of T-cell lymphomas, a group of malignant tumors of the immune system that are often fatal.

The long-term goal of Dr. Feldman's research is to improve the lives of patients with T-cell lymphomas through individualized therapy in which a group of laboratory tests can predict — with high accuracy — the treatment most likely to be effective in an individual patient.

To accomplish this, Dr. Feldman's team makes extensive use of next-generation sequencing technologies and innovative bioinformatic approaches to discover key genetic abnormalities in T-cell lymphomas.

The team then screens large numbers of T-cell lymphomas to determine whether such testing for these abnormalities can improve the diagnosis and subclassification of the tumors. In the laboratory, the biologic consequences of the novel genetic abnormalities are tested to determine whether new drugs might be used to specifically target tumors with a given abnormality.

Together, these findings can be translated to the clinic in the form of new laboratory tests that help select the right therapy for the right patient.

Focus areas

• What are the basic genetic changes that lead to T-cell lymphoma? Most lymphomas are driven by underlying genetic changes that lead to abnormal cellular growth. While these changes are becoming more clearly understood in B-cell lymphoma, T-cell lymphomas remain relatively understudied.

  Dr. Feldman is working to characterize the genetic abnormalities that lead to T-cell lymphoma and the biologic consequences of these abnormalities in the tumor cells. This biologic understanding can lead to the development of better therapies.

  In addition, laboratory testing for genetic abnormalities can be used to diagnose T-cell lymphoma, offer information about prognosis, and predict which drugs are most likely to be effective for an individual patient.

• How can pathologists provide better diagnosis of lymphoma? Lymphomas and most other cancers are currently classified according to the type of normal cell that became cancerous.

  While this classification system has benefits, it does not provide comprehensive information about the genetic changes that occurred in the original cell and made it cancerous. These genetic changes can determine many important features of the tumor, such as how fast it will grow and what treatments it may respond to.

  Dr. Feldman is working to learn how pathologists can better classify lymphomas so that pathological diagnoses offer the most useful information to the hematologists and oncologists who treat cancer patients.

Significance to patient care

Dr. Feldman's research into the molecular pathogenesis of T-cell lymphomas is leading to new laboratory tests to help diagnose lymphomas, while also contributing to the development of new approaches to treat patients with these diseases.