According to results recently presented at the 7th annual meeting of the European Hematology Association, the treatment combination of Rituxan® (rituximab) and thalidomide demonstrates significant anti-cancer activity in patients with relapsed mantle cell lymphoma.
Non-Hodgkin’s lymphoma is a cancer of the lymph tissue, which is part of the body’s immune system. Lymph tissue is present in lymph nodes, lymph vessels and bone marrow, which exist throughout the body. It is also present in organs such as the thymus, tonsils and spleen. The main cells in the lymph system are called lymphocytes, of which there are 2 types: B and T-cells. Each of these cells has a specific function in aiding the body to fight infection. The large majority of NHL cases involve cancer of the B-lymphocytes, characterized by the excessive accumulation of these atypical cells. These cancerous cells can crowd the lymph tissue, thereby causing suppression of normal formation and function of other cells necessary for normal immune functions. While NHL is categorized by the type of lymphocyte it involves, it is also further defined by the specific appearance of the affected cells, as well the grade of the disease (how fast it is likely to grow). These determinations are based on how the cells look under a microscope. In terms of NHL grade, high-grade or aggressive NHL is the fastest growing.
Mantle cell lymphomas are a high-grade, aggressive type of NHL, with average survival of less than 3 years and few long-term survivors. Although patients may have an anti-cancer response to initial therapy, some patients may experience a recurrence or relapse of their cancer. Patients with relapsed mantle cell lymphoma tend to be difficult to treat with conventional therapies and researchers are evaluating novel therapeutic approaches in order to improve survival and/or quality of life for these patients.
Mantle cell lymphoma has demonstrated some anti-cancer responses to treatment with Rituxan®; however, at present there has not been extensive research with the use of Rituxan® and mantle cell lymphoma. Rituxan® is a relatively new biologic therapy and has shown promise in the treatment of B-cell NHL. It is still being evaluated in various cancers and treatment approaches. Rituxan® is a monoclonal antibody that binds to proteins on the surface of B-lymphocytes. This binding stimulates the immune system to attack and kill the cancerous B-cells and may be directly involved in cellular death. A significant benefit of this approach is that Rituxan® only targets cancer cells (B-cells), thereby sparing healthy cells from destruction. This is important for patients who have recently undergone high-dose therapy and may not be able to tolerate severe side effects.
Thalidomide is an agent that has demonstrated anti-cancer effects in various cancers. Thalidomide is known to possess anti-angiogenesis properties and researchers are still investigating other means by which thalidomide may produce its effects in cancer, including modulation of the immune system and inflammatory responses. Recently, researchers in Austria conducted a small clinical trial to evaluate the combination of Rituxan® and thalidomide in 10 patients with relapsed mantle cell lymphoma. Following therapy, 9 of the 10 patients experienced an anti-cancer response. Of these responders, three achieved a complete disappearance of cancer (remission) lasting approximately 14 months, 11 months and 7 months, respectively. Five of the six patients who had a partial anti-cancer response to therapy had not experienced disease progression between five to 18 months of therapy. Treatment was generally well tolerated.
These researchers concluded that Ritxuan® and thalidomide produces significant anti-cancer responses in patients with relapsed mantle cell lymphoma. In addition, the responses tended to last and treatment was well tolerated. Although this was a small clinical trial, these results warrant further evaluating of Rituxan® and thalidomide in the treatment of relapsed mantle cell lymphoma. Patients with relapsed mantle cell lymphoma may wish to discuss the risks and benefits of participation in a clinical trial evaluating Rituxan® and thalidomide or other promising therapeutic approaches. Two sources of information regarding ongoing clinical trials include the National Cancer Institute (
www.eCancerTrials.com. eCancerTrials.com also provides personalized clinical trial searches on behalf of patients.
Reference: Drach J, Kaufmann H, Schwab B, et al. Treatment with rituximab plus thalidomide shows marked anti-tumor activity in relapsed/resistant mantle cell lymphoma. Proceedings of the 7th Annual Meeting of the European Hematology Association. Florence, Italy. June 2002.
Drach J, Kaufmann H, Schwab B, et al. Treatment with rituximab plus thalidomide shows marked anti-tumor activity in relapsed/resistant mantle cell lymphoma.
The Hematology Journal. 2002;3:abstract 1199.
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