First off, my congratulations to the U.S. Ryder Cup team, which beat the Europeans this weekend. The match was held in beautiful Louisville, Kentucky, where we spent five wonderful years. The U.S. team was led by Paul Azinger, NHL survivor, featured in my last Nodes of Gold entry. Gotta love it when lymphomaniacs do well. And you gotta love Boo Weekley.
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There seems to be a ton of great lymphoma- and cancer-related news coming out lately, all of which is very encouraging. Two great stories from the last week.
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First, there is a report on a variation of an already-effective chemo treatment. Some background: The chemo is called CHOP, the acronym for the combination of drugs given to lymphoma patients. It's fairly aggressive, and has always been reasonably effective. A few years ago, it became known as R-CHOP. The R was for the addition of the monoclonal antibody Rituxin, the NHLer's best friend. Rituxin is sometimes used as a first line, initial treatment for Follicular NHL (my current plan is for straight Rituxin as my first treatment), but is even more effective when combined with chemotherapies. Rituxin targets lymphoma cells because they have a protein called CD-20 on their surface. Researchers aren't sure exactly why the addition of Rituxin makes the chemo work better, but it does.
This recent news has to do with another monoclonal antibody called Epratuzumab, which targets a different protein, CD-22. In this recent study, CHOP was combined with both Rituxin and Epratuzumab (the combo is called ER-CHOP). The numbers in the clinical study are pretty impressive: 56% of patients had a complete response (they went into full remission), and another 38% had a partial response (reduction in tumors). For fNHL patients, that's pretty darn good news.
There's a clinical trial underway that uses Epratuzumab and Rituxin in combination as a first line treatment; a reader of this blog, Dave, is in the trial and should get results soon. Good luck, Dave.
The best part of Epratuzumab is that it is being marketed under the name LymphoCide. That name rocks.
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The other interesting news from this week concerns Follicular NHL and treatments after relapse. Basically, fNHL has a bad habit of coming back after being treated, so patients face a series of treatments, which are usually effective is holding off the lymphoma, or beating it back for a while, until the next treatment is used. The treatments are usually progressively more aggressive; you start with Rituxin, then if/when it comes back, you use a certain chemo, then a stronger chemo, then R-CHOP -- or whatever the doctor and patient decide what the course of treatment will be. The assumption has always been that fNHL becomes more aggressive with time, and so each treatment must be more aggressive.
As it turns out, not all fNHL behaves this way. Researchers have identified 81 genes that can determine very accurately if the fNHL is going to behave more aggressively with time. Knowing that can help determine a better course of treatment, going with something more aggressive earlier on, or holding off because things will keep going slowly. Another excellent step for better treatment.
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It's nice to hear all of this great fNHL news coming about. I expect to hear about some very interesting new treatments in the next few years, partly because of the Stand Up to Cancer folks. Cancer research funding usually depends on a researcher showing how he or she is building on previous effective work, which increases the chances that the funding will result in something good happening from the research. The result is slow, incremental progress, which is great. Stand Up to Cancer is taking a different appraoch. They're funding "dream teams" of cancer researchers to take their best ideas, some of them fairly radical, and giving them a chance to show that they'll work. They might be so new and unusual that they don't have that kind of history that the slow, incremental work has to have to get funded. Could be a waste of money, but it could result in some very interesting cancer treatments.
Keep looking here for news, of course.
Thank you for continuing to do research on fNHL information. I too have fNHL (diagnosed 4/16/08), am waiting and watching so far. I keep your blog in my favorites!
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