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A Good Day for Patients With Lymphoma

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brontoyounes.jpgThis year, approximately 11,000 patients combined will be diagnosed with Hodgkin lymphoma (HL) and anaplastic large cell lymphoma (ALCL). Compared to other cancers, such as breast and lung, these two lymphomas are considered relatively rare cancers. So, chances are, you didn't hear the news about brentuximab vedotin (SGN-35), which is now called Adcetris.  

HL and ALCL are potentially highly curable types of lymphoma when conventional chemotherapy regimens and radiation therapy are used. For this reason, no new drugs have been approved by the U.S. Food and Drug Administration for Hodgkin lymphoma since 1977.

But if you are one of the unlucky ones who aren't cured with these conventional regimens, today is a good day for you. Indeed, it's a good day for all of us. A good day for humanity.

A new drug has been approved

Today, the Oncologic Drugs Advisory Committee/ODAC, an FDA advisory panel, voted 10-0 to recommend accelerated approval for Adcetris to treat patients with relapsed Hodgkin lymphoma after having a stem cell transplant, and for patients with relapsed or resistant systemic ALCL.
 

Adcetris (Brentuximab vedotin), which is made by Seattle Genetics, combines an antibody that targets CD30 receptor with a toxic drug. This combination is called Antibody Drug Conjugate (ADC, hence the first three letters in the name Adcetris).

The ADC binds to CD30, which is mainly expressed on lymphoma cells, and enters the cells to deliver the toxic drug. By doing so, the toxic drug is specifically delivered to the tumor cells with little toxic effect to normal cells.  
 
The Hodgkin lymphoma study
In the HL study, 102 patients (median age 31) who had previously failed an autologous stem cell transplant were treated with the single agent Adcetris (given by 30-minute intravenous infusion every three weeks, for up to 16 doses). Patients had a median of four previous chemotherapy regimens and some had as many as 13 previous regimens.

The overall objective response rate (complete and partial remissions) was very impressive at 75%, with approximately one-third of patients having complete remission. Many patients who achieved complete remission continued to be free of disease for a long time. 

The Anaplastic Large Cell Lymphoma study
The  ALCL trial involved 58 patients (age 18-64) who were treated in the same way as HL patients. Of the participants, 86% achieved either partial or complete remission, with 57% experiencing complete remission. The average duration of the complete remission was more than one year (13.2 months).
 
This is a good beginning. Adcetris is being combined with front-line regimens that are used to treat patients with HL (ABVD) and ALCL (CHOP) to improve the cure rate. Other combinations in the relapsed settings also are planned.
 
This is a perfect example of why patients with cancer should participate in clinical trials, even though they involved drugs in Phase I early development. When we started the Phase I of SGN-35 (before it was named brentuximab vedotin and now Adcetris), it was 2007.
 
For many patients, a drug that was identified by letters and numbers (SGN-35) was their only hope. For those who participated in the original first-in-man Phase I study -- some of whom are alive and well -- they know very well that they weren't guinea pigs. They made a big difference for themselves,and for many others to come.
 
This may look like one small step for man in the overall war on cancer. But, without a doubt, it's a giant leap for Hodgkin lymphoma and anaplastic large cell lymphoma patients.
 
It's a good day for all of us in the trenches fighting cancer.
 

6 Comments

Dr ,
My name is Bill McGillan (44 yrs) and have recently relapsed with Hodgkin's after 4 yrs remission. Needless to say, my family and I are devistated. I had lymph tissue removed from my lower right lung and it was confirmed to be Hodgkins. 7 years ago I did ABVD, followed by a stem cell transplant and finally I did radiation. I feel great and just finished a 6.5 mile Mud Run for M.S. so I was really taken back when the results came back. My Dr is considering a stem cell transplant with my sisters stem cells (if they are a match) or radiation followed by sgn-35. I will be getting a 2nd opion at University of Penn (Dr Shuster) on 10th August. I'm looking for any information, feedback or advice you could give me. I have 2 young children and I don't want to die on them.

Thanks for your time,
Bill McGillan

My husband has refractory CLL He has had Bedamustine-and Ofatumumab still has disease will this work for this type of CLL - large B cell

My husband follicular nhl transformed into DLBCL and i am so afraid right now about his case. He received 6 cycles of R-CHOP and he had partial response after 2 months the tumor went back to pre-RCHOP size. We still have small children 1 and 6 years old. Does this medication works with his kind of cancer?

According to the MD Anderson Manual of Medical Oncology, R-CHOP is listed as a treatment option for patients with over 60 years of age and relapsed or refractory (resistant to treatment) diffuse B-cell lymphoma. Other treatment options are bone marrow/stem cell transplant, and clinical trials.

I hope this information is helpful. If you have any further questions, or would like information about MD Anderson services, programs, or appointment information, please feel free to contact me again.

Best wishes,
Heather Henry
Health Information Specialist, askMDAnderson Public Education Office

Hi there,

My wife (28yrs old) was just diagnosed to have stage IV Anaplastic Large Cell Lymphoma (T-cell) on 20/04/2012. According to PET scan result, she got a tumor mass at pelvic bone, several lymph nodes near some internal organs and a tumor mass at scalp. The scalp bone was already eroded by the tumor, which finally was resected surgically. Her histopathological reports showed that her Anaplastic Lymphoma Kinase (ALK) is positive and the haematological oncologist said this kind of lymphoma is the most curable one among the entire ALCL. However, according to all above her symptoms, her international prognostic index value is really not satisfactory. The doctor said her relapse possibility is high in future.

At present, She has already recevied 4 cycles of CHOP treatment. PET scan also done before the 4th chemo and it was shown that her body is clear of the cancer cells!! However, the doctor then said that due to the fact that she was in very poor condition when diagnosed, well metastasized, she suggested her to undergo allogenic bone marrow transplant after finishing 6 CHOPs. My wife was so scared of the transplant because she knows the rejection possibility is very high. We heard that there is a very new drug called "Brentuximab" approved for treatment on relapsed or refractory systemic ALCL when the patient failed to one prior multi-agent chemo. I am now wondering if we should consider Brentuximab...or....receive allogenic bone marrow transplant when relapse occurs in future. Actually this new drug is not available in Hong kong and no one was received before. Therefore, no prior treatment protocol is present here. I would like to share with your experiences and suggestions.

Thanks for your kind help!

Hi Gilbert, please email social@mdanderson,org and we'll put you in touch with Dr. Younes.

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