Thursday, May 29, 2014

ASCO: Bortezomib (Velcade) for Follicular Lymphoma

More good news from ASCO about that "new, awesome stuff": a positive report on Bortezomib, which I will refer to as Velcade.

Velcade is a proteasome inhibitor. Proteasomes are  necessary for cells to function properly. They break down and clean up proteins in cells (including cancer cells), helping the cell stay alive. When proteasomes are inhibited, the proteins pile up in the cell like dirty clothes in my son's bedroom. This causes the cell to die. Velcade has already been approved for use on multiple myeloma and relapsed mantle cell lymphoma.

The ASCO presentation is focused Indolent NHL, including Follicular Lymphoma, particularly on patients with High Tumor Burden (which means they have a tumor larger than 7 centimeters, or close to 3 inches; they have nodes in 3 different areas that are more than 3 centimeters, or an enlarged spleen, or nodes that are pressing on organs).

The researchers gave Velcade and Rituxan to patients who were getting their first treatment. There were 42 patients overall, with 33 of them having Follicular Lymphoma (the rest had other indolent lymphomas). The results: overall, 70% of patients received a response, with 40% achieving a Complete Response. For the FL patients, the results were even better: 76% Overall Response, 44% Complete Response. Side effects seemed manageable.

The researchers mention that we need more long-term follow-up on treatments like this, and they offer a 4 year follow-up. They divide patients into FLIPI scores (I won't get into what that means, though it's basically a measure to guide treatment, and to compare patients in clinical trials. I recommend for more on FLIPI scores.) Lower scores had better Progression Free Survival and Overall Survival.

And I love this statement from the abstract: "Interestingly, 4-year OS was superior for FL compared with non-FL histologies." "Superior," in this case, means that 97% of the Follicular Lymphoma patients were still alive after 4 years. That's a dang good number.

The bottom line: In this small sample, Velcade and Rituxan worked as well as chemo and Rituxan, but with fewer side effects thanks to the targeted nature of the combination.

Great news. More to come.


Jackie said...

Thanks for posting this article. By-the-way, are you looking forward to the movie "Get On Up"? It's the new James Brown bio-pic slated for release soon.
Thank you again for your blog

Lymphomaniac said...

I've seen the trailer, and the movie looks pretty great. I just had someone tell me a story about James Brown, and how he helped put someone through college, who then went on to do pretty great things. He was a complex man. I think the movie will show that.
Still, I'll always love him in the Blues Brothers.
Thanks for reading.