<Since rituximab and CHOP chemotherapy have nonoverlapping toxic effects with some evidence of in vitro synergy, it was logical to study the combined use of both modalities. A phase 2 study conducted by Czuczman and colleagues accrued 31 chemotherapy-naive patients and 9 previously treated patients with low-grade lymphoma.[101] Treatment consisted of rituximab, 375 mg/m2, on day 1 of each cycle, followed by standard CHOP on day 3 for a total of 6 courses. Thirty-five of 40 patients completed all 6 cycles of CHOP and 6 cycles of rituximab. The ORR in the intent-to-treat group was 95%, with 22 CRs (55%). The 2 nonresponders (5%) were withdrawn from the study before initiation of therapy, so in the evaluable treated group, the response rate was 100%. At 29 months, the median duration of response and time to disease progression have not been reached. During this follow-up period, 28 patients (74%) remained in continued remission, 24 of whom were previously chemotherapy naive with follicular histologic findings. Subset analysis revealed that the lowest response rate occurred in patients with bulky disease (45%).>
Rich, thanks for the link. It's nice to see some progress. Nice too, at last, to see some progress with combined therapies though my favourite "Early All-Out War" therapy, such as Oncolym/ Rituxan/CHOP/Zevalin/Bexxar/Vaccine which would make a lot of lymphoma cells really miserable isn't in use yet by the look of it.
Attacking various antigens while using CHOP and radiation would leave few avenues of escape for the lymphoma cells if treatment is early enough, rather than waiting for billions of multitalented and mutated lymphoma cells to develop, by which time a total victory is impossible.
It would be nice to slip some dendritic cell vaccines in too while the nuking and poisoning is going on [in case any lymphoma cells are sneaking away with hidden CD20 and Oncolym antigens and a CHOP-hardened shell]. There would not be many lymphoma cells escape after that onslaught.
"In the coming decade" might be a bit soon, considering the languid pace of developments. But I'm ever optimistic. As the IDEC share price shows, there is a LOT of profit to be made if somebody comes up with some serious lymphoma killing systems.
Mqurice |
