Velcade Bummer

The most recent issue of The Lancet Oncology was given an online preview earlier this week, and one of its articles focused on a promising Follicular NHL treatment, Velcade. Unfortunately, it looks like it's not going to live up to its promise.

The article is called, "Bortezomib Plus Rituximab Versus Rituximab Alone in Patients with Relapsed, Rituximab-Naive or Rituximab-Sensitive, Follicular Lymphoma: A Randomised Phase 3 Trial." As the title implies, the study looked at patients who were given only Rituxan, and those who were given a combination of Rituxan and Velcade. Basically, the study found no real difference between the two in terms of effectiveness.

Velcade (also known as Bortezomib) is one of those treatments that Dr. R has mentioned to me recently. It's a really interesting treatment, one that I've written about before. It works by, basically, keeping cancer cells from taking out the garbage. All cells create waste, and they have a mechanism that lets them expell that waste. Velcade blocks that mechanism, so the cancer cells kill themselves the way the people on those weird hoarding shows do, with piles of garbage in their houses that eventually crush them. It's a really cool mechanism for killing cancer cells.

What this study did was randomize about 700 fNHL patients: roughly half were given Rituxan, and the other half were give Rituxan + Velcade. They found that Progression-Free Survival (or PFS -- how long the cancer was kept away) was 11 months for the straight Rituxan group, and just under 13 months for the Velcade group. That's a little bit of an improvement, obviously, but not enough to set off any leftover fireworks.  (The reseachers had anticipated about a 33% improvement in PFS, which would have been roughly 16 months. That in itself seems like kind of a low bar, but so it goes with improvements in cancer treatments. There are few improvements that really blow anybody away and add months or years to existing treatments' PFS.)

The conclusion to all of this? "The regimen might represent a useful addition to the armamentarium, particularly for some subgroups of patients." Translation: "Yeah, sure, it's one more thing to try for some people, but it's not the Big Answer we were looking for."

So, in the end, sucky news. But Velcade is still a good treatment for there another type of NHL, Mantle Cell Lymphoma, which is great. And the study did provide some good news: it helped us understand that this wasn't what we were looking for, and lets us focus on something else.

Gotta look at the bright side....