Treating Non-Hodgkin's Lymphoma with new Radioimmunotherapy
Non-Hodgkin's Lymphoma is a form of cancer that affects the blood, bone marrow and lymphatic tissues, and is currently a leading cause of cancer-related deaths in the United States. Nationwide, it's expected to claim the lives of 19,400 people this year and has the second-fastest growing mortality rate. In Michigan alone, approximately 2,000 people are diagnosed with the incurable disease each year.
St. John Providence Health System is one of only a handful in the state that offers the BEXXAR radioimmunotherapy treatment for non-Hodgkin's lymphoma patients.
“The main driving force in setting up the BEXXAR treatment is that we want to make sure we have the latest treatments available to our patients," said Ayad Al-Katib MD, director of the Van Elslander Cancer Center at St. John Hospital and Medical Center. "That way we have the most options and can tailor treatment for every patient (with non-Hodgkin's Lymphoma)."
The BEXXAR regimen is the newest radioimmunotherapy treatment on the market and offers promising results for those patients with B-cell lymphoma containing CD20 positive protein molecules present on the cancer cells. Approximately 80% of all non-Hodgkin's lymphoma patients have this type. BEXXAR eligible patients must also have either low grade (slow growing) lymphoma, or transformed, when the disease has progressed from low to an intermediate grade.
Another requirement is that the patient's disease is refractory or not responding to the antibody treatment Rituximab, a form of immunotherapy, and has relapsed following chemotherapy treatments.
"BEXXAR treatment is promising because it works entirely different from the mechanisms of chemotherapy. If a Lymphoma patient becomes resistant to one kind of chemotherapy, chances are the patient won't respond to other forms of chemotherapy. BEXXAR gives us another option for treatment," explained Dr. Al-Katib, a nationally recognized lymphoma expert and professor of medicine at Wayne State University.
BEXXAR combines the targeting ability of a B-cell monoclonal antibody (Tositumomab) and the therapeutic potential of radiation (Iodine -131). Unlike traditional or external radiation, the radioactive component in radioimmunotherapy is bound to the antibody, allowing it to be injected into the blood stream where it seeks target B cells and delivers a dose of radiation. Dr. Al-Katib says it's a practical and effective way to use the tumor killing power of radiation to diffuse disease.
"BEXXAR and Zevalin (a similar radioimmunotherapy regimen for non-Hodgkin's lymphoma patients also available to patients) both deliver an added punch to the cancerous cell because it has radiation attached to it."
The BEXXAR therapy has been studied for over 13 years. In a multi-center, single-arm, clinical trial in patients who had received an average of four prior chemotherapies and who had Rituximab-refractory disease, 63% (22 out of 35 patients) responded to BEXXAR. The average duration of response was 25 months. Subsequent clinical trials were also encouraging and supported the clinical benefit of BEXXAR, even though this treatment and radioimmunotherapy in general is not a cure for non-Hodgkin's lymphoma.
After being treated with BEXXAR, less than 5 percent of patients suffered hair loss or developed severe nausea, vomiting or mucositis (sores in the mouth or gastrointestinal tract). And while it does offer hope for patients, BEXXAR is not without side effects. The majority of patients typically experience very low blood counts for about a month after treatment. Infections occurred in almost half the patients, bleeding in one of eight, and treatment with supportive care in approximately one of four patients. Allergic reactions, including anaphylaxis have occurred in patients receiving BEXXAR.
Other less severe reactions patients may experience during or following the infusion include fever, chills, sweating, nausea, low blood pressure, shortness of breath and labored breathing. In addition, patients may also experience weakness, increased cough, infection, pain, rash or headache. There is a risk of hypothyroidism following the administration of BEXXAR. Certain cancer therapies, including BEXARR have been associated with the development of a second type of blood cancer and solid tumors, such as leukemia and myelodysplasia.
BEXXAR was developed by Corixa Corporation and is co-marketed in the United States by Corixa Corporation and GlaxoSmithKline. To access additional information, call 1-877-4BEXXAR or visit www.BEXXAR.com.