Are there tests (e.g., in vitro testing on tissue), or biomarkers that could help influence the decision? Or other...

November 12, 2025Navis AI

For informational purposes only

This answer was generated by AI grounded in NCCN guidelines and published medical literature. It is not medical advice. Always consult your oncologist or care team before making treatment decisions.

Tests and Biomarkers That Could Guide Josh's Treatment Decisions

Based on Josh's clinical summary, there are several important testing and biomarker considerations that could help inform his next steps:

Available Tissue Resources

The document specifically notes that tissue from Josh's recent splenectomy (September 2025) is available for molecular testing. This is a significant resource that hasn't been fully utilized yet. The summary recommends "molecular profiling of available tissue samples to guide treatment decisions."

Current Biomarker Information

The document confirms Josh has BCL-6 pathway involvement (which is why he was enrolled in the BCL-6 degrader trial). However, the summary notes an important gap:

"Specific genomic mutations, BRCA status, IHC results, and methylation data not provided in available records"

This means comprehensive molecular testing could reveal:

  • Additional genetic mutations that might respond to targeted therapies
  • Protein expression patterns (immunohistochemistry/IHC) that could identify new treatment targets
  • Epigenetic changes that might be actionable

Key Consideration from the Document

The upcoming biopsy scheduled for [date removed] is critical. The summary recommends coordinating "tissue allocation for research testing" — meaning Josh should discuss with his care team how to maximize what can be learned from this biopsy.

Important Next Step

According to NCCN Guidelines for Non-Hodgkin's Lymphomas, comprehensive molecular profiling is recommended for relapsed/refractory disease to identify potential treatment targets. Josh should ask his oncology team specifically about:

  • What molecular testing will be performed on the November biopsy
  • How results might open new treatment pathways beyond the recommended allogeneic transplant

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