The May 12 edition of the Journal of Clinical Oncology had an interesting twist on the Rituxan Maintence issue, reporting on an early study on subcutaneous application of Rituxan -- a quick, single injection rather than a long intravenous drip.
There was actually a report on subcutaneous Rituxan a couple of months ago in the journal Lancet Oncology, which found that the injection was non-inferior to the current IV method, and didn't present any new safety concerns. That was a different study, with a different research team.
The very recent report from the JOC is a little bit different. The focus is on whether or not a Rituxan injection can be useful as a way to deliver Maintenance Rituxan.
The study is in two stages. The first stage focused on figuring out how much of a dose would be the same as the traditional IV. So 124 Follicular Lymphoma patients were divided into two groups, with half receiving the injection, and half getting it through the traditional IV. In the end, the study predicted that the injection would require 1400 milligrams of Rituxan.
In stage 2, a new crop of 154 Follicular Lymphoma patients were divided into two groups. One was given the 1400 milligram dose of the subcutaneous injection, and the other was given the IV. This stage found that the two types of application were pretty comparable -- the same percentage of patients had side effects of various types, and the concentration of Rituxan in the blood was about the same for the two groups.
So, basically, this study was set to determine just what that injection should include if it was going to be the same as the traditional IV. The next step will be to determine if it actually works as well.
While this study doesn't really get into why a Rituxan injection would be preferable to an IV, those of us who have had Rituxan by IV already know -- a quick shot is a heck of a lot better than a 4 hour drip, assuming its as safe and effective as the drip. The earlier study was more clear about its larger aims -- a quick shot can reduce costs.
Two fairly successful studies? I think this thing is going to happen some day. It's still early in the process, but so far, so good.