Magazine article Drug Topics

New Antibody Combo Offers Hope for NHL Patients

Magazine article Drug Topics

New Antibody Combo Offers Hope for NHL Patients

Article excerpt

HEALTH-SYSTEM EDITION

CLINICAL PRACTICE For the first time, a combination of two monoclonal antibodies suggests that synergistic targeted therapy for non-Hodgkin's lymphoma (NHL) may be on the horizon.

Early results of a phase II clinical trial of the novel cancer therapeutic epratuzumab combined with rituximab show enhanced efficacy over that which has been reported with rituximab alone. Significantly also, rituximab's safety profile remains unchanged with the addition of the second, very different antibody The results were reported in a poster presented at the American Society of Clinical Oncology annual meeting, held in Orlando, Fla., last month.

Another drug, Zevalin (ibritumomab tiuxetan, IDEC) was recently approved for NHL and is also used in combination with rituximab (for more, see page HSE29).

Rituximab binds to the cell surface protein CD20 (target molecule); epratuzumab binds to CD22. The preliminary study looked at 21 patients with relapsed and refractory NHL whose disease had progressed despite prior treatment with chemotherapy The two antibodies were administered together, once weekly for four weeks, using this IV dosage: epratuzumab 360 mg/m2 and rituximab 375 mg/m2.

Lead investigator John P Leonard, M.D., medical director, oncology services, and assistant professor of medicine, Weill Cornell Medical College, told Drug Topics: "Complete response rates with the mixture are higher than one would expect with rituximab alone. But side effects compare with what we see with rituximab alone." He added enthusiastically: "We are hopeful when we see a consistent pattern of results as the number of treated patients increases and the duration of responses seen in follow-up grows." Early clinical data also suggest that epratuzumab has the shorter infusion time-one hour compared with four to six hours for rituximab. That could translate into saved time and money one day, he observed.

In his presentation, Leonard emphasized the following findings:

The patients-men and women median age 63-with the indolent form of the disease had an overall objective response (complete and partial responses combined) of 63% (10 out of 16 patients). This is still in the range of what is usually seen with single-agent rituximab. …

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