New Therapy Offers New Hope for Treating Advanced-Stage Lymphoma
Treating Advanced-Stage Lymphoma
Oncologists have been stymied by how to treat some patients with lymphoma who do not respond to new, targeted therapies. A study by scientists at the University of Rochester Medical Center and other institutions shows there might be a new drug that combats indolent non-Hodgkin's lymphoma when others fail.
Bendamustine, an agent that attacks cancer cells' DNA forcing them to self-destruct and disrupting the cell-division cycle, was given to 77 patients, most of whom had advanced follicular lymphoma, who did not respond to rituximab, considered the wonder-drug for lymphomas, and 74 percent of them responded, including 35 percent who were brought into remission.
"This is very exciting because it's the first study of chemotherapy for a class of patients who didn't respond to rituximab and it provides an effective alternative for them," said Jonathan Friedberg, M.D., of the James P. Wilmot Cancer Center at the University of Rochester Medical Center. He presented results of the international study today at the American Society of Hematology's annual meeting in Atlanta.
"It's unusual to see this kind of response in patients so far along in the course of their disease, especially since they previously did not response to other alkylators and were relapsed from rituximab," said Friedberg, associate director of lymphoma clinical research at Wilmot.
About half of follicular lymphoma patients respond to rituximab as a single agent, and a standard treatment is with a chemotherapy combination called CHOP. Doctors have struggled with how to treat people who don't respond, or stop responding to that therapy. It's common for patients with follicular lymphoma to relapse multiple times during the typically 10-year natural progression of the disease.
"Typically these patients need several different therapies over the years and none of them are curative. This data suggests that bendamustine will add to our treatment options for this disease," Friedberg said.
The phase II study focused on heavily pre-treated, older patients with Stage 3 or Stage 4 disease who were treated at 17 centers between 2004-05.
The 74 percent response rate included 35 percent of the patients in total remission, along with 39 percent who had a partial response. Seven percent of the patients' disease was stable, and another 16 percent had disease progression. The average length of response was six months.
Bendamustine is being developed by Cephalon Oncology, which funded the clinical trial. Participating sites included Georgetown University, University of Alabama at Birmingham, M.D. Anderson Cancer Center, Dana-Farber Cancer Institute, University of Virginia, Pacific Oncology & Hematology Associates and Desert Regional Medical Center in California, and Queen Elizabeth II Health Science Center and Ottawa Hospital in Canada.
A phase III study of bendamustine is underway for patients with indolent non-Hodgkin's lymphoma who are resistant to rituximab. The Wilmot Cancer Center is accruing patients for this study.