Adding Drug to Standard Care May Prolong Lymphoma Survival

From - September 27, 2017

Adding Rituximab to Standard Care May Prolong Lymphoma Survival

WEDNESDAY, Sept. 27, 2017 -- Long-term treatment with the drug rituximab (Rituxan) may extend the lives of some patients with a rare form of blood cancer, a new clinical trial finds.

The disease, known as mantle-cell lymphoma, is generally incurable. But various treatments can prolong people's lives. Some patients, for instance, are able to undergo chemotherapy to wipe out the cancer cells, followed by a stem cell transplant -- to restore normal blood cells.

But while that approach can be effective for a while, most patients see the cancer come back.

So the new trial, funded by Rituxan maker Roche, looked at whether an additional step could help: Having patients take Rituxan for three years following their stem cell transplant.

Overall, researchers found, the tactic did improve patients' outlook. After four years, 83 percent of rituximab patients were still alive and progression-free -- versus 64 percent of patients who had standard treatment alone.

Experts said the findings should have an immediate impact on patients' treatment.

"This should be considered a new standard of care," said Dr. Anas Younes, chief of the lymphoma service at Memorial Sloan Kettering Cancer Center, in New York City.

However, there are concerns with the long-term use of rituximab, according to Younes, who was not involved in the study.

The drug suppresses the immune system, so infections are always a risk, he noted.

"But," Younes added, "the benefits seem to outweigh the risks."

Dr. Steven Le Gouill, of Nantes Medical University, in France, led the study.

He agreed that "rituximab maintenance" -- using it long-term, after a stem cell transplant -- should become a new standard.

"The gain in terms of overall survival should encourage hematologists to prescribe rituximab maintenance for transplanted patients," Le Gouill said.

Mantle-cell lymphoma is one of about 70 subtypes of non-Hodgkin lymphoma, according to the Leukemia & Lymphoma Society. In the United States, about 4,200 people are diagnosed with the disease each year -- most commonly, older men.

Doctors have long used rituximab to treat certain cancers, including mantle-cell lymphoma. The drug is a lab-engineered antibody that latches onto a protein on white blood cells (lymphocytes) called B cells; those are the cells that are affected in mantle-cell lymphoma.

As it stands, rituximab is used along with high-dose chemotherapy drugs to wipe out the cancerous B cells. Some patients then undergo an "autologous" stem cell transplant. That means they have some of their own blood-forming stem cells removed before their drug regimen; afterward, the stem cells are infused back into the body, to restore new, healthy blood cells.

Some patients -- including those who are older and frail -- cannot have a transplant.

Continue reading at »