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Promising New Agents for Lymphoma Presented Today at ASCO

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Younes2a.jpgAt today's Clinical Science Symposium at ASCO, Dr. Nancy Bartlett of Washington University presented data from an ongoing Phase I study of SGN-35, an immunotoxin conjugate targeting CD30, in patients with relapsed and refractory Hodgkin's lymphoma and anaplastic large cell lymphoma.


SGN-35 was given weekly for three weeks every 28 days for a maximum of 12 cycles. Nine of 22 patients with relapsed Hodgkin's lymphoma and four of five patients with anaplastic large cell lymphoma responded.

Treatment-related toxicity was not significant. This data complement our original data using the same drug given every three weeks, which is currently in a pivotal trial seeking approval by the FDA. This could be the first drug approved for patients with relapsed Hodgkin's lymphoma in more than three decades, and will hopefully become a building block of future non-chemotherapy-based regimens that are less toxic but remain curative.

Dr. Izidore Lossos from the University of Miami presented data on a novel organic arsenic molecule darinaparsin. Twenty-eight patients with relapsed lymphoma were treated with the drug given intravenously for five consecutive days, every three weeks. Seven of 19 evaluable patients responded with minimal toxicity. Oral formulation is currently being investigated in Phase I studies in advanced malignancies, including lymphoma.

Finally, Dr. Bruce Cheson of Georgetown University presented data on the novel survivin inhibitor YM155. Survivin is a member of the Inhibitor of Apoptosis (IAP) family, which became an appealing target for cancer therapy. Based on preclinical data and results from a previous Phase I study suggesting a potential therapeutic value in patients with diffuse large cell lymphoma, a Phase II was conducted. Dr. Cheson reported that 35 patients were treated with YM155 given by intravenous infusion. One patient achieved partial remission and several others had stable disease.

I discussed that paper and congratulated the investigators and the sponsor for the remarkable achievement of moving this targeted therapy from discovery to a completion of a Phase II study in a rather short period of time. I then discussed the challenges of drug development in aggressive lymphoma and pointed out that correlative studies and rationally designed combination studies will be needed to advance the field and change the standard of practice.

It is an exciting time for clinical research in lymphoma, as several new agents are currently being combined with front-line regimens and salvage regimens in randomized international trials. Patients are encouraged to participate in these studies, so we can learn which agent will change the natural history and improve the cure rate of patients.

However, in addition to combining these new agents with standard chemotherapy regimens, we also must combine several new agents and identify predictive markers so that we can move forward with a more personalized lymphoma therapy.

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