Two Targeted Therapies Likely Better Than One in Patients with Aggressive Lymphoma, Mayo Clinic Resea...(the steroid drug prednisone and rituxima...),Health

Diffuse large B-cell lymphoma is one of the most common and aggressive forms of non-Hodgkin lymphoma, a cancer of the B-lymphocyte white blood cells.

The researchers are the first to study the addition of epratuzumab to R-CHOP in newly diagnosed, untreated patients. Both epratuzumab and rituximab are monoclonal antibodies that attach to proteins commonly found on the outside surface of B cells -- CD20 for rituximab and CD22 for epratuzumab. They are also used as immunosuppressive agents to treat certain autoimmune diseases where B cells produce antibodies that attack a person's own cells. "These drugs are designed to shut down B cells, whether they are involved in autoimmunity or are malignant," Dr. Micallef says.

Rituximab is approved for use by the Food and Drug Administration, while epratuzumab is not. That means ER-CHOP treatment cannot be used outside of a clinical trial.

In addition to the results on overall survival, the researchers found an 82 percent progression-free survival in the group. The 39 high-risk patients had a 77 percent PFS, and, for the 39 low-risk patients, PFS was 88 percent. Patients are deemed high risk if they have three or more poor prognostic factors, such as age (60 years or older), elevated LDH (a blood test), advanced disease stage, disease outside of lymph nodes and poor physical performance status.

Dr. Micallef says that the treatment, which is given every 21 days, was well tolerated by patients.

The study drug, epratuzumab, was provided by Immunomedics, Inc. The research was funded by NCCTG, a national clinical research group based at Mayo Clinic and sponsored by the National Cancer Institute. NCCTG consists of a network of cancer specialists at community clinics, hospitals and medical centers in the United States, Canada and Mexico.

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