No Velcade for Follicular?

The makers of Velcade have withdrawn their application with the FDA to approve Velcade in combination with Rituxan as a treatment for Follicular NHL.

This really isn't all that surprising. I wrote a few months ago about the very disappointing clinical trial that had been conducted on Velcade, one that found that Velcade + Rituxan added only about 2 months more to the progression-free survival for fNHL than straight Rituxan did by itself. It's unlikely doctors would start using this combination, given the potential side effects compared to those of straight Rituxan. The risk just isn't worth the relatively tiny reward.

Velcade won't go away forever -- it's still very effective with some other types of lymphoma. Apparently, the makers might start focusing more now on the more aggressive Diffuse Large B Cell Lymphoma. Plus, Velcade still has a chance to do well with some other combinations. This article from August talks about the possibility that Velcade may still be important for Follicular NHL because it makes other chemotherapies work better. If that's the case, then the studies that look at Velcade only on its own, or Velcade in combination with a non-chemo treatment like Rituxan, would of course not be as successful.

So, the bottom line seems to be, we probably haven't heard the last of Velcade yet. It's just too good in theory, and too successful in practice on other NHLs, to abandon completely at this point.