Maintenance Rituxan® Is Safe for Follicular Lymphoma

Posted on March 8th, 2009 by

Maintenance Rituxan® Is Safe for Follicular Lymphoma

Continued treatment for up to two years with Rituxan® (rituximab) is a safe therapeutic approach for the treatment of follicular lymphoma. These results were recently presented at the 2008 annual meeting of the American Society of Clinical Oncology.

Non-Hodgkin’s lymphoma is a form of cancer that begins in the cells of the lymph system. The lymph system includes the spleen, thymus, tonsils, bone marrow, lymph nodes, and circulating immune cells. The main cells in the lymph system are lymphocytes, of which there are two types: B- and T-cells. Each cell type has a specific function in helping the body fight infection.

Non-Hodgkin’s lymphoma is characterized by the excessive accumulation of atypical (cancerous) lymphocytes. These lymphocytes can crowd the lymph system and suppress the formation and function of other immune and blood cells. Non-Hodgkin’s lymphoma is categorized by the type of lymphocyte it involves and by the rate at which the cancer grows.

Follicular lymphoma is a type of NHL that is considered to be a low-grade or indolent lymphoma, meaning it is a slow-growing subset of NHL. Commonly, the targeted agent Rituxan is used as part of the treatment regimen for follicular lymphoma, as it binds to a specific component of B-cells. Once Rituxan binds to B-cells, which are cancerous in the majority of NHL cases, the cells are killed by the immune system. Rituxan also appears to have other anticancer mechanisms, which are currently being evaluated.

Treatment for follicular lymphoma often includes initial therapy, referred to as induction therapy, as well as continued therapy, referred to as maintenance therapy. Maintenance therapy is used for extended periods to provide continued suppression of the cancer. Results from several clinical trials have demonstrated that maintenance Rituxan improves both overall and progression-free survival for patients with follicular lymphoma; however, further investigation is necessary into safety concerns with extended use of the Rituxan as maintenance therapy as well as among patients who have received different therapeutic regimens as initial therapy.

Researchers from the M.D. Anderson Cancer Center recently conducted a clinical trial to evaluate the safety of use of Rituxan as maintenance therapy among 349 patients with follicular lymphoma. Patients in the trial had achieved anticancer responses with initial treatment including Rituxan. On the trial they received maintenance therapy with Rituxan, given once every eight weeks for up to two years.

  • Other than a stroke suffered by one patient, no safety issues were reported within 24 hours of administration of Rituxan.
  • Hematologic (blood-related) side effects occurred in nine patients, three of whom experienced severe (grades III/IV) low levels of immune cells (neutropenia).
  • Overall, a total of nine safety issues were reported; however, only one of these was thought to be potentially related to treatment with Rituxan.
  • Some initial therapies were identified that appeared to be associated with an increase in side effects when followed by maintenance Rituxan.

The researchers concluded that, for up to two years, “[Rituxan] maintenance [every] 8 weeks in FL after [Rituxan]-containing induction therapy can be safely administered.” Longer follow-up of patients on maintenance Rituxan therapy may provide further information about the safety of even longer maintenance therapy. Patients with follicular lymphoma who achieved anticancer responses to prior Rituxan may wish to speak with their physician regarding their individual risks and benefits of maintenance therapy with Rituxan.

Reference: Wenger M, Foa R, Arcaini L, et al. Safety in patients receiving maintenance rituximab for follicular lymphoma: results from the phase IIIb MAXIMA trial. Proceedings from the 2008 annual meeting of the American Society of Clinical Oncology. 2008. Abstract #8606.

Related News: Rituxan® Improves Prognosis Among Patients with Follicular Lymphoma (02/11/2008)

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