New Treatment Regimen Cures Many Cases of Follicular Lymphoma

Internal Medicine World ReportApril 2005

New Treatment Regimen Cures Many Cases of Follicular Lymphoma

By Rebekah McCallister

A new treatment for patients with advanced-stage follicular lymphoma—a cancer not generally considered curable—that takes less time and causes fewer side effects than chemotherapy caused tumors to shrink in 95% of patients, according to a new study published in the New England Journal of Medicine (2005;352:441-449).

The study included 76 patients with advanced-stage follicular lymphoma who had not been treated previously with any other kind of therapy. They received a single course of treatments with this new regimen of radioactive iodine (I131) and monoclonal antibody tositumomab (the Bexxar therapeutic regimen) that is injected into the bloodstream and targets and kills cancer cells. Of these patients, 95% responded to the treatment and 75% had a complete response (ie, cure). Patients were found to be disease-free 5 years posttherapy.

“The results of this treatment, which essentially takes only 1 week to complete, rival any kind of treatment that’s been used for follicular lymphoma, including chemotherapy regimens that take months to complete,” said lead investigator Mark Kaminski, MD, director, the Leukemia/Lymphoma Program and the Multidisciplinary Lymphoma Clinic, U-M Comprehensive Cancer Center, Ann Arbor, Mich.

Dr Kaminski and Richard Wahl, MD, both of Johns Hopkins University, Baltimore, Md, developed the Bexxar regimen that combines the potential of an antibody looking for cancer cells and radioactive iodine, to take advantage of these 2 mechanisms that together could kill cancerous cells. The regimen was approved in 2003 to treat follicular non-Hodgkin’s lymphoma after other treatments have failed.

The most common side effect is temporary lowering of blood counts for several weeks after treatment; no hair loss occurred and instances of nausea were infrequent.

“Given how much better this treatment worked as first-line therapy, moving this treatment up earlier in the course of a patient’s illness should be strongly considered, instead of using it as a last resort or not at all,” Dr Kaminski said. “These results support the notion that there’s a real possibility of putting chemotherapy on the back burner for this disease.”

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