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Treatment targets non-Hodgkins lymphoma MUSC Hollings Cancer Center has begun treating patients fighting relapsed or refractory follicular non-Hodgkin’s lymphoma with BEXXAR (Tositumomab and Iodine I 131 Tositumomab), a treatment that uses radiation bound to an antibody to target cancer cells directly inside the body. MUSC participated in clinical trials of the BEXXAR therapeutic regimen that supported  the recent U.S. Food and Drug Administration (FDA) approval. “The BEXXAR therapeutic regimen represents a new generation of cancer treatments because it is targeted specifically at non-Hodgkin’s lymphoma cells, is given at a dose tailored for each individual patient, and is delivered in a short treatment course,” said Debra Frei-Lahr, M.D., an MUSC medical oncologist and hematologist. “Most important, BEXXAR allows us to offer real hope to patients with follicular non-Hodgkin’s lymphoma who have exhausted other options.”  The BEXXAR therapeutic regimen, which  is approved by the U.S. Food and Drug Administration (FDA) for the treatment of patients with CD20 positive, follicular, non-Hodgkin’s lymphoma, with and without transformation, whose disease is refractory to the antibody treatment Rituximab and who have relapsed following chemotherapy.  The BEXXAR therapeutic regimen is given in four visits during a one to two week period and is not indicated for the initial treatment of patients with CD20 positive non-Hodgkin’s lymphoma. “Patients with follicular non-Hodgkin’s lymphoma usually respond well to initial courses of chemotherapy or antibody therapy and may enjoy remissions lasting several years,” said Frei-Lahr. “However, because this form of non-Hodgkin’s lymphoma is generally incurable, most patients will eventually require additional therapy.  Unfortunately, with each subsequent treatment, we traditionally see fewer and shorter responses, until the disease progresses within only a few months or fails to respond at all.  It is the demonstrated potential of BEXXAR to produce long-term durable responses in patients whose disease is not responding to other treatments that is so encouraging.”  BEXXAR is a dual-action therapy that pairs the tumor-targeting ability of an antineoplastic (cancer killing) monoclonal antibody (Tositumomab) and the therapeutic potential of radiation (Iodine-131) with patient-specific dosing.  Combined, these agents form a radiolabeled monoclonal antibody (Iodine I 131 Tositumomab) that is able to bind to the target antigen CD20 found on non-Hodgkin’s lymphoma cells, thereby initiating an immune response against the cancer and delivering a dose of radiation directly to tumor cells.  BEXXAR is the only non-Hodgkin’s lymphoma therapy that is specifically dosed based on an individual’s drug clearance rate, allowing the delivery of a pre-determined amount of radiation to each patient  The BEXXAR therapeutic regimen, which has been studied for more than 10 years, demonstrated independently confirmed durable responses (responses with a time to progression of at least 12 months) in heavily pre-treated patients with follicular non-Hodgkin’s lymphoma. In a clinical trial in patients who had an average of four prior chemotherapies and who had Rituximab-refractory disease, 63 percent responded to BEXXAR. Half of these patients had a response that lasted 25 months or longer.  “Not only does BEXXAR offer promising improvement in therapeutic response, but the patient is extremely relieved to learn that the side effects are dramatically less than those they experienced with other lymphoma therapeutic regimens,” said Kenneth M. Spicer, M.D., Ph.D., co-director of nuclear medicine. “After completing the dosimetric imaging, they return for 10 to 20 minute recline in a lounge chair while the radioactive monocolonal antibody is infused, and they get up to resume their normal daily activities. This is a very pleasant surprise for most patients, especially considering that BEXXAR is so very likely to help melt away their disease.” About Non-Hodgkin’s Lymphoma Non-Hodgkin’s lymphoma is a form of cancer that affects the blood, bone marrow and lymphatic tissues. Non-Hodgkin’s lymphoma currently is the sixth-leading cause of cancer-related deaths in the United States, is expected to claim the lives of 23,400 Americans this year, and has the second-fastest-growing mortality rate.  According to statistics from the National Cancer Institute (NCI), approximately 300,000 people are afflicted with non-Hodgkin’s lymphoma in the United States alone.  Of that total, 25 to 40 percent have follicular non-Hodgkin’s lymphoma, making it the second most common type. Transformed non-Hodgkin’s lymphoma is an aggressive and difficult to treat form of follicular non-Hodgkin’s lymphoma with a particularly poor prognosis. Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to petersnd@musc.edu or catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Community Press at 849-1778.