Immunotherapy Combinations That Treat NHL

Immunotherapy uses your own immune system to help treat cancer. While your doctor might prescribe this kind of treatment on its own, it can also be combined with other treatments like chemotherapy and radiation.

Many people do better when chemo and immunotherapy are used together, but taking more than one medicine can cause more side effects. Combination therapies cost more, too.

Right now, scientists are testing more than a thousand different combinations. It's too soon to know if these are safe or work better than treatments we have now, but some doctors think immunotherapy is the future of cancer care.

R-CHOP

One of the most common treatments for non-Hodgkin's lymphoma is a type of chemo called R-CHOP. It's made up of three chemo medicines -- cyclophosphamide, hydroxydaunomycin, and vincristine (one brand is Oncovin) -- along with the steroid prednisone. That's the "CHOP" part. The "R" stands for an immunotherapy drug called rituximab (Rituxan), which is a monoclonal antibody. It's made in a lab to track down and destroy the cells where lymphoma starts.

Rituximab is sometimes added to other chemo treatments, too. Most use a combination of medications because each one attacks cancer in a different way.

R-CHOP causes side effects for most people. Some of these, like a high fever and very low white blood cell count, are life-threatening. You might also feel queasy, throw up, and have heart trouble or seizures. You'll get medicine before and after treatment to help ease these symptoms.

Antibody-Drug Conjugates

This type of immunotherapy combines a monoclonal antibody like rituximab with a single chemo drug. The antibody acts like a missile to send chemo deep inside lymphoma cells. This may work better than chemo alone and might not cause as many side effects.

One example is a drug called brentuximab vedotin (Adcetris). Your doctor might try it if your cancer comes back after other treatments. You get it through an IV, what doctors call an infusion, once every 3 weeks. A common side effect is damage to nerves in your hands and feet.

Radioimmunotherapy

This treatment works like antibody-drug conjugates, but the antibody is attached to a radioactive molecule. It carries a dose of radiation straight into tumor cells. It might still affect some healthy cells nearby, but far less than more traditional kinds of radiation therapy.

Your doctor may prescribe a medicine called ibritumomab tiuxetan (Zevalin) if you have follicular cell lymphoma that comes back or isn't helped by other treatments. Some of the most serious side effects of radioimmunotherapy are very low blood counts and the chance you'll get another kind of cancer.

WebMD Medical Reference Reviewed by Laura J. Martin, MD on May 30, 2018

Sources

SOURCES:

Pharmacy and Therapeutics: "Impact of Rituximab (Rituxan) on the Treatment of B-Cell Non-Hodgkin’s Lymphoma."

Nature: "The benefits of immunotherapy combinations."

CURE: "Immunotherapy Strategies Emerging in Lymphoma."

UpToDate: "Patient education: Diffuse large B cell lymphoma in adults (Beyond the Basics)."

National Cancer Institute: "Adult Non-Hodgkin Lymphoma Treatment (PDQ®)–Patient Version," "R-CHOP," "Brentuximab Vedotin Approved for Two Rare Lymphomas."

Dana-Farber Cancer Institute Insight: "How is Immunotherapy Used to Treat Lymphoma?"

American Cancer Society: "Immunotherapy for Non-Hodgkin Lymphoma."

Zevalin.com: "ZEVALIN Mechanism of Action."

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