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Non-Hodgkin's Lymphoma

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New Treatments for Non-Hodgkin's Lymphoma

The rate of non-Hodgkin's lymphoma has nearly doubled since the 1970s, but advances in treatments are offering new hope.

NHL Treatment: From Neutral to 180

For decades, treatments for non-Hodgkin's lymphoma remained stuck in neutral. Conventional chemotherapy beat back disease and kept many people in remission, especially for slow growing lymphomas. But each time lymphomas return, they learn to better survive these toxic drugs.

By turning new scientific breakthroughs into new medicines, however, cancer specialists are raising the ante.

"There have been enormous advances over the past 10 years in our fundamental understanding of what makes a cancer cell a cancer cell," says Owen O'Connor, MD, a Memorial Sloan-Kettering Cancer Center medical oncologist. "Understanding these developments has given rise to a panoply of new drugs."

Antibody Therapy for Non-Hodgkin's Lymphoma

One new hope came in the 1990s, when researchers learned how to mass-produce antibodies against a kind of immune B-cell found in 90% of non-Hodgkin's lymphomas. Called monoclonal antibodies, they kill lymphoma cells by harnessing the power of the human immune system.

How it works: Monoclonal antibodies are given as part of a chemotherapy regimen; they stick to lymphoma cells and the immune system attacks and kills the tumor cells.

The FDA approved the first monoclonal antibody, Rituxan, in 1998 for treatment of lymphomas that failed conventional chemotherapy. Oncologists, excited by promising early data, quickly embraced this new weapon and believed Rituxan would work not just on relapsed lymphoma, but on early disease as well.

Their hunch was right: People with certain lymphomas treated with a combination of chemotherapy and Rituxan do better and live longer, regardless of the disease's stage.

As a result, leading medical centers have adopted Rituxan as part of standard treatment for most non-Hodgkin's lymphomas.

"In practice, we see improvements in all of them," Felipe Samaniego, MD, a medical oncologist at The University of Texas M.D. Anderson Cancer Center, tells WebMD.

For practicing academic oncologists today "it's an exciting time," says Oliver Press, MD, oncologist at University of Washington and director of the Lymphoma Research Foundation Advisory Board. "It's gratifying to see the antibody therapies gain a major role and give a great benefit to patients."

Benefits like fewer side effects than traditional chemotherapy. That's because, unlike standard chemotherapy, which is toxic to normal body cells, Rituxan targets only lymphoma cells.

"Antibodies are much gentler on patients," says Press. "[Rituxan] is very mild chemotherapy. You don't get the infections, toxicity, or drop in blood counts" of conventional chemotherapy.

However, there is the potential for rare but serious reactions, such as breathing or heart problems, during or shortly after Rituxan is infused into the body.

Radioimmunotherapy: Raising the Odds of Remission

In 2002, new versions of monoclonal antibodies arrived. Called "radioimmunotherapy," or RIT, they combine a radioactive substance with the antibody, increasing its killing power against tumor cells.

These new letters in the alphabet soup of chemotherapy show immense promise in improving and possibly prolonging life with NHL.

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