WebMD Health News
Louise Chang, MD
June 4, 2007 (Chicago) -- Nearly nine in 10 people with lymphoma given a relatively new type of treatment that combines cancer-killing antibodies and radiation are still alive eight years after being treated, researchers report.
The study also showed that half of people with previously untreated follicular lymphoma have not suffered a relapse since undergoing a one-week treatment with Bexxar.
Follicular lymphoma is a common form of non-Hodgkin's lymphoma and accounts for about 15% of all cases. It’s a cancer of the lymph tissue, an important part of the immune system.
Bexxar combines the antibody (tositumomab) with radioactive iodine and is administered through an infusion. The antibody stimulates the body's immune system to fight the cancer.
“The big advantage is that Bexxar is given in one week, with very little toxicity,” says researcher Mark Kaminski, MD, professor of internal medicine at the University of Michigan Comprehensive Cancer Center in Ann Arbor.
“In contrast, traditional chemotherapy regimens require several months of therapy and is associated with a variety of toxicities,” he tells WebMD. Side effects of conventional chemo include nausea, hair loss, and infections.
Bexxar was approved by the FDA in 2003 for the treatment of follicular non-Hodgkin's lymphoma in patients who have not responded to initial therapy with the drug Rituxan and who have relapsed following chemotherapy. But this is the first study to use the drug in previously untreated patients.
The study included 76 people with advanced follicular lymphoma (stage III and IV) who had not yet been treated for their disease. The patients were given a one-week treatment with Bexxar and were followed for about eight years.
The research was presented here at the American Society of Clinical Oncology’s annual meeting.
Results showed that 95% of the patients responded to the treatment; 75% had a complete disappearance of the signs of their cancer.
At follow-up, the estimated eight-year overall survival rate was 86%. Fifty percent of patients continued to show no signs of cancer. Of the 57 patients who had a complete remission, two-thirds remained in remission.
Kaminski says the toxicity or hazardous side effects of Bexxar were moderate, and none of the patients treated required transfusions or suffered serious therapy-related complications.
When injected, Bexxar acts like a homing missile, traveling through the bloodstream and binding to a protein found on the surface of the cancerous cells. The radiation zaps and kills these malignant cells while generally sparing healthy tissue, he says.
Mitchell R. Smith, MD, director of the lymphoma service at Fox Chase Cancer Center in Philadelphia, says the drug shows promise for the treatment of people with previously untreated follicular lymphoma.
“But I’d be hesitant to use it in such patients outside of a clinical trial until we see further study comparing its safety and effectiveness to chemotherapy,” he tells WebMD.
That said, both Kaminski and Smith say Bexxar is being vastly underutilized in those patients for whom it is approved -- that is, those who relapse after chemotherapy.
“Fewer than 10% of patients who could benefit are getting it,” Kaminski says.
The reason, the doctors say, is that most patients are initially seen by so-called medical oncologists who can deliver chemotherapy right in their office. In contrast, Bexxar treatment requires “a complex schema, with coordination between the medical oncologist, the radiation oncologist, the radiopharmacy, and others,” Smith explains.
“People who are candidates for Bexxar should talk to their doctor about this approach,” Kaminski advises.
SOURCES: 43rd Annual Meeting of the American Society of Clinical Oncology,
Chicago, June 1-5, 2007. Mark Kaminski, MD, professor of internal medicine,
University of Michigan Comprehensive Cancer Center, Ann Arbor.Mitchell R.
Smith, MD, director of the lymphoma service, Fox Chase Cancer Center,
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