My Buddy Z

....By which I mean Zevalin, the RIT (RadioImmunoTherapy) treatment that I've written about several times before. More good news about its effectiveness.


To review: "Liquid" cancers like NHL are hard to treat with radiation because the cancer cells don't hold still -- there's nothing to aim the radiation at. The development of Rituxin, an antibody that recognizes B cells (including the cancerous ones) and attaches to them, was a huge advance for lots of reasons (and even more reasons are popping up). Zevalin (and its cousin Bexxar) are basically radioactive Rituxin -- Zevalin attaches itself to the B cells and delivers a dose of radiation to them. It's a pain to administer (you need to assemble a team of nurses, radiologists, and nuclear medicine specialists to do it), but in theory, it's a great therapy, combining a couple of different types of treatment. But studies are trickling in to show that it's meeting that great theoretical promise.


The October issue of the Journal of Clinical Oncology includes an editorial from Oliver W. Press, a researcher from the Fred Hutchinson Cancer Research Center and University of Washington in Seattle. (He's a big name from a big research center).


In a nutshell, Press reviews a couple of recent clinical studies of Zevalin, and while he points out some problems with the ways the studies were conducted, he's very hopeful about the results, and thinks they signal a huge advance in treating indolent lymphomas like Follicular NHL.


As Press points out, Zevalin has been used up top this point as a "down the line" treatment -- when chemo stops working, you turn to RIT. It's been fairly successful when used this way.


However, a major new study looked at Zevalin as a first-line treatment. In other words, the study looked at people who were given Zevalin before they received any chemo or other treatments. The results were impressive: patients given either Zevalin by itself, or Zevalin combined with chemo, showed 90-100% response to the therapy, with up to 90% showing complete response (the lymphoma was wiped out, at least temporarily).

A second study that Press describes looked at using higher-than-normal doses of Zevalin after a shortened course of chemo (three doses instead of the usual six), and also came with encouraging results. The chemo wiped out a lot of the cancer cells, and the Zevalin took care of the rest. Combining the treatments means attacking in different ways, and increasing the chances that you'll hit more of the cancer.

This morning, I read about a third, similar study that looked at a patients with advanced follicular NHL (they were in the "bulky" stage, meaning their nodes were more than 10 centimeters, or about three inches), who were given a shortened course of chemo, followed by Zevalin, then followed by Rituxin. Similarly good results -- nearly 90% of patients were still in remission after two years. The study is ongoing.

It's all very encouraging, not just for the results themselves, but because they should inspire more people to try Zevalin (or Bexxar) and encourage researchers to keep tinkering with dosages, sequences, and follow-ups. I'm convinced RadioImmunoTherapy is going to play a bigger role in treatments soon, and we (the NHL community) are all going to be happy we gave it a chance.