Best Treatment Plan for Follicular NHL?

All right, the whole First Rituxan Infusion thing went well, but it's time to get back to work.


If you're new to Lympho Bob, or you've started reading again after an absence, then you should know that I'm a cancer research geek, and I like to provide links to new lymphoma research here. Family and friends seem to like to hear about new developments, because it gives them hope, and my fellow fNHLers who have found the blog seem to like being up-to-date on potential options.


I get these links from a couple of Facebook groups, from postings to my support group, and through my own research. Recently, someone in the support group posted an article from the journal The Oncologist from a year or so ago, called "Radiolabeled and Native Antibodies and the Prospect of Cure of Follicular Lymphoma." The full article is available here.


It's on the technical side, written for oncologists, but it was worth wading through. The article is a review of research on fNHL, looking especially at Rituxan and RadioImmunoTherapy (RIT -- Zevalin and Bexxar); those are the Radiolabeled (RIT) and Native (Rituxan) antibodies mentioned in the title. The basic conclusion of the article is that a combination of Rituxan (or some other native antibody), Zevalin or Bexxar, and some chemotherapy is probably the best currently available way to treat Follicular NHL. The big HOWEVER here is that the authors are speculating, based on previous research -- this isn't a report of new research. It amounts to a kind of "best practices" summary.

Rituxan, they say, has done wonders for the treatment of fNHL (which we already knew). And RIT has also been fantastic. What's great is that they work in two different ways. Combine either of them with chemo, which works in a third different way, and the results are even better. So maybe combining all three together in some way (Rituxan with the chemo, then conditioning with Rituxan before RIT) might the best shot we have at a cure, or at least a long-term remission for fNHL.


More importantly, both native antibodies and radiolabeled antibodies could fairly easily be improved. Rituxan is great, but fully-humanized antibodies (no more mouse fantasies!), or antibodies that target proteins besides CD-20, might mean even greater success. And RIT could be improved by playing with the ways the radioactivity is released (that's the real technical part of the article) and then giving repeat applications of it. Combine those improvements with chemo, and you have an even better chance at cure/long-term remission.

Or so they speculate.

A very interesting idea, and one that doesn't even consider the ways other improvements might help (like genetic testing helping to determine which of the chemo options might be best). Certainly something worth considering for an fNHL patient who is taking Rituxan and might be moving on the CVP, and who has an obsession with radiolabeled antibodies.....