Follicular Lymphoma: What's New

OncLive published a piece yesterday called "Numerous Drug Classes Studied for Use in Follicular Lymphoma." It's basically a summary of what Lymphoma Rock Star Dr. Bruce Cheson had to say at the International Congress on Hematologic Malignancies, which took place in February.

The article notes that there are no new chemotherapies under development for Follicular Lymphoma.

This is a good thing. A very good thing.

It means that researchers have pretty much abandoned the idea that shotgun approaches to treating cancer are no longer necessary. We know enough about the genetics of cancer that we can be more targeted in our approaches to finding and killing cancer cells. Unlike traditional chemo, these newer treatments don't kill as many healthy cells, so there is less toxicity and fewer side effects.

None of that is news, of course, to anyone who pays attention to these things. (Like me.)

But it is nice to have such a neat summary of all of the treatments that researchers are focusing on: according to the article, these include "monoclonal antibodies, signaling pathway targeting agents, apoptosis-inducing compounds, and immunomodulatory drugs."

Even better, some of the specific treatments are available in convenient chart form.

Some highlights (in my opinion):

• Rituxan will soon lose its patent protection. We'll see more anti-CD20 monoclonal antibodies soon. They won't necessarily be generic copies, but may be more effective than Rituxan. (Which will be hard to pull off. Most new monoclonal antibodies have roughly the same effectiveness.)
• Obinutuzumab (GA101) is showing mixed results. A lot hinges on the results of a trial that combines it with bendamustine.
• Ibrutinib is being tested in a phase 2 trial. So far, it had shown to be effective for up to 2 years in patients with Follicular Lymphoma that has returned after an initial treatment. The formal trial will give more information about effectiveness and toxicity.
• Idelalisib (GS- 1101), another kinase inhibitor, is also doing very well. One trial involving Idelalisib (GS- 1101) has it combined with either Rituxan, Bendamustine, or both, and is kicking butt no matter which combination is used. 
• Another trial combining Lenalidomide and Rituxan in untreated Follicular Lymphoma patients yielded a 98% response rate. Cheson called it "astounding," which seems like a pretty good word to use.

Cheson points out, too, that all of these great treatments will need to be tested, and so we'll need some folks who are willing to enroll in clinical trials.

Overall, some really excellent news in the piece, even if most of it is still stuff that's in the pipeline and not yet ready for use on everyday patients.

But we're getting there.

That quiver is filling up with arrows pretty quickly.