Thursday, March 6, 2014

Improved RadioImmunoTherapy for Follicular Lymphoma?

I need to get back to my blog. Shoulder sling or not, I've got to get on with my life. As I said, you know things are going great when you can distract yourself by writing about cancer....

I'll probably do a little less commentary than I'd like, but that will give me something to build up to.

This news is almost a couple of weeks old now, but it's exciting. Researchers at the University of Manchester in England are looking into RadioImmunoTherapy as a front-line treatment for Follicular Lymphoma. Zevalin has been approved as for use in FL after a first treatment has stopped working, and as a way to extend a successful first treatment. This study is showing that we can skip the Rituxan or CHOP and just get right to the RIT.

The study was published in the Journal of Clinical Oncology (I still haven't had a chance to read the full article). What makes this approach special is that the researchers gave the RIT in two smaller doses, rather than one big one. This seemed to have allowed it to better penetrate larger tumors (the patients in the study had bulky disease, or larger tumors), and also seemed to cut down on side effects.

And it worked well: 94.4% of the 72 patients had a response, and 69.4% had a Complete Response. Those are some dang good numbers.

Are they good enough? I hope so, but it will still be a struggle to get people to recognize just how great RIT is. Bexxar is gone, and one of the hurdles that Zevalin faces is the difficulty that comes with administering it. (It can't be done in an oncologist's office, but rather needs a team of nuclear medicine specialists to do it.) Hard enough to get it all done once; will it be even harder to accept if all that effort has to be made twice? At the very least, it won't make it any easier.

Sorry for the negative slant on this. I guess the positive look on it is that it gives us one more way of considering how to use RIT effectively.

I'll try to write something sunnier next time. Or not wait until the Percocet is almost worn off....


Anonymous said...

Hey Bob,

My first comment; too many similarities: Diagnosed with Follicular Lymphoma last August, did my Rituxan in November, now in remission. But back in 2000 I had shoulder surgery; I was 44. Yes, right rotator cuff, tendon shred to, well, shreds. You'll be fine as long as you do physical therapy with single-minded determination. I remember coming back from the hospital, drugs wearing out, and realizing I couldn't lift my arm more than a few inches. I had young kids and I was in a panic that I'd never be able to lift them up again. It took time and at least 2 months of intense, painful stretching with a therapist to come back to almost normal (my left shoulder can still stretch more, but functionally both shoulders are fine; can't complain). My right bicep had atrophied on top of everything else but I always liked lifting weights so my arms are back to a similar size.

I read your blog every day. Thank you.


Lymphomaniac said...

Wow, Aris -- pretty amazing similarities. I hope you hurt yours doing something cooler than slipping on ice. Maybe rescuing a litter of puppies or something? Anyway, I really appreciate the encouragement, and the advice to be good about PT. I hope your FL continues to stay in check.

Anonymous said...

It's been a few days since I checked my favorite blogs. An awful cold -- and as I'm certain others with cancer have discovered, a cold is no longer merely a cold; I suspect every little ache as being a symptom of something far more ominous.

In terms of my shoulder, I do wish I had a heroic tale. Alas, nothing traumatic happened. Just years of using a joint that never caught up with evolution: arms in evolutionary terms are modified legs best suited for 4-legged animals. According to my surgeon, the way we use our shoulders -- lifting above our heads, throwing stuff, etc. -- is forcing the rotator cuff through challenging and unnatural locomotion. A misplaced bone spur may eventually slice the tendon. I wish I had saved puppies instead!


Lymphomaniac said...

Aris, Glad you are getting over your cold. And I certainly understand that you'd be worried about it being something else. I still feel that way sometimes, even after 6+ years, though that anxiety gets less and less over time. All part of the Follicular Lymphoma game, I guess.
Evolution and overuse are to blame for the shoulder? Ugh. That's daunting. I'm going to just go with a story about puppies....