Friday, October 25, 2013

Revlimid, Rituxan, and Follicular Lymphoma

About to be published in the journal Cancer (as straightforward a journal title as you're ever going to find): "Combined Lenalidomide, Low-Dose Dexamethasone, and Rituximab Achieves Durable Responses in Rituximab-Resistant Indolent and Mantle Cell Lymphomas."

Come to think of it, that article title is pretty straightforward, too: R + R (Rituxan + Revlimid,also known as Lenalidomide, plus a little something extra, helps Follicular Lymphoma patients (and others) who are no longer helped by Rituxan.

It's a pretty small study (phase 2, with 24 patients, when all was said and done), but an important one.

Revlimid/Lenalidomide is a pretty cool treatment. It works in a few different ways, mostly by messing with the processes that cancer cells seem to need in order to survive, inhibiting new blood vessels from growing, and changing the immune system in favorable ways that researchers haven't fully figured out yet (but it works, so who cares).  It seems like, when combined with Rituxan, it could boost Rituxan's effects, especially for patients who have grown resistant to Rituxan (which, unfortunately, does happen).

This study looked at 24 patients, including 18 with Follicular Lymphoma. There were two parts to the study: in part 1, patients were give Revlimid plus a small dose of dexamethasone, a steroid. In part 2, they were given those again, plus some Rituxan.

After part 1, there was about a 29% response rate (either a complete or partial response). But in part 2, when the Rituxan was added, the response was 58%, with 8 of the patients achieving a complete response. As for follow up, the median progression-free survival was just under 2 years. Pretty dang good for patients who were told that Rituxan wasn't going to work for them any more.

The big takeaway is just that -- Revlimid might help resistant patients use Rituxan again.

While there are already a bunch of other fairly low-toxicity treatments other than Rituxan, and a bunch more in development, there's some comfort in knowing that Rituxan works, and so it's good to find a way to have it keep on working. (Plus, there has so far not been much to come down the pipeline that has been a major improvement on Rituxan. I'm biased, of course, given that Rituxan is among my closest friends....)

Nice to see a small pick up in Follicular Lymphoma-related studies in the news in the last few days. I hope there are more to come soon.

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