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| |  ASCO: Relapsed Mantle-Cell Lymphoma Responds to Rituximab and Thalidomide Therapy By Ed Susman NEW ORLEANS -- June 7, 2004 -- Patients with a relapse of difficult-to-treat mantle cell lymphoma can achieve durable responses with a combination of rituximab and thalidomide, researchers noted here on June 6th at the American Society of Clinical Oncology 40th Annual Meeting. Standard treatment for mantle cell lymphoma involves doxorubicin, cyclophosphamide, vincristine, and prednisone (CHOP), but that regimen has had little success against disease relapsed, said Johannes Drach, MD, professor of medicine, University of Vienna, and medical oncologist, University Hospital, Vienna, Austria. "When we treated [relapsed] patients with thalidomide, we were able to stabilize disease," Dr. Drach noted during his poster presentation. "We realized that we needed something more on top of that. When we added rituximab we saw synergistic effects and durable responses." Those responses resulted in a prolongation of survival, and some even occurred in heavily pretreated patients who had undergone high-dose chemotherapy. Of 16 patients with relapsed mantle cell lymphoma, 13 responded and 5 of those responses were complete -- with some lasting at least 29 months, Dr. Drach said. One patient achieved stable disease. The median time to progression was 20 months. Duration of response was greater than 20 months, said Dr. Drach. "We believe that in lymphoma, thalidomide is having some effect on the cytokines necessary for cell signaling," Dr. Drach noted. "Since the microenvironment plays an important role for growth and survival of malignant B cells, we hypothesized that a treatment strategy targeting both the tumor cell and the microenvironment could be active in mantle cell lymphoma." Mantle cell lymphoma occurs most often in older people, so warnings against the use of thalidomide in women who may become pregnant are not usually necessary, although the researchers excluded women of childbearing age from the thalidomide trial, Dr. Drach pointed out. "That has not been an issue for us, however, because most of these patients are men, and the age range has been from 45 years to 67 years," he said. "Based on the results we have seen so far, we are encouraged enough that we now offer patients with relapsed mantle cell lymphoma a front-line treatment of CHOP plus thalidomide," said Dr. Drach. He also stated that a clinical trial has been initiated using the rituximab-CHOP-thalidomide regimen.
[Study Title: Durable Remissions After Rituximab Plus Thalidomide for Relapsed/Refractory Mantle Cell Lymphoma. Abstract 6583]
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