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Targeted Therapy Hits Relapsed, Resistant Hodgkin Lymphoma

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A good thing about Hodgkin lymphoma is that frontline combination chemotherapy cures 80% of patients. A bad thing about Hodgkin lymphoma is that there has been no standard therapy for the other 20% after chemotherapy, radiation and blood stem cell transplant fail.

A new, highly targeted therapy seems on course to change that. The drug is an antibody that homes in to a surface protein found almost exclusively on Hodgkin lymphoma and other rare lymphomas. Once there, the drug enters the cell and unloads a toxic chemical.

Of 45 patients in a Phase I clinical trial, 17 (38%) had an objective response to the drug, 11 complete remissions and six partial. Results from a Phase I trial of SGN-35 are reported in the Nov. 4 New England Journal of Medicine. CT scans showed 36 of 42 patients (86%) had their tumors shrink.

"That level of objective responses to a drug is impressive for a Phase I trial," says study lead author Anas Younes, M.D., professor in MD Anderson's Department of Lymphoma/Myeloma. "These encouraging results are being confirmed in a large Phase II trial, the results of which are expected to be released in December."

Seattle Genetics developed the drug, also known as brentuximab vedotin, by linking an antibody to the CD30 protein with a potent cytotoxin to form a conjugate medication.

For years, drug companies neglected Hodgkin lymphoma because the population of people with relapsed or resistant disease is small. The American Cancer Society estimates that 8,490 new cases will be diagnosed in 2010 and 1,320 people will die of the disease.

"Hodgkin lymphoma patients have waited 40 years for a new therapy," Younes says. "The potential impact on years of life saved is huge because the median age for this disease is in the 30s."

BryanCrowell.jpgBryan Crowell, 41, a lawyer in Atlanta, remains in remission more than two years after completing the trial. This video includes Bryan's story.

Jason Sonnier, 35, moved home to Louisiana after his computer tech job at Enron disappeared with the company in 2001. Two years later, a sore throat led to a Hodgkin lymphoma diagnosis. He went through chemotherapy and radiation, a brief remission, followed by more treatment, finally undergoing high-dose chemotherapy and a blood stem cell transplant. Relapse occurred, more radiation followed.  

In early 2008, Jason entered the clinical trial. He had an allergic reaction to the second dose and went off the drug. However, about a month later, his disease went into remission.

"It's been a long road and this is one of my longest stints without treatment," Jason says. "I'm clean and clear, and that's good."



Resources
Armed Antibody Triggers Remissions for Hodgkin Lymphoma  (News release 10/3/2010) 
MD Anderson Lymphoma Resources on Facebook
Follow Dr. Younes on Twitter



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