Expanding the Use of Rituxan ... Video Transcript

Participants

, Robert Marcus MD, Oliver Press MD, PhD, Brett Scott

Summary

In recent years, the drug Rituxan has become a well-established option only for certain forms of non-Hodgkin's lymphoma (NHL) There are other types of NHL where Rituxan may be beneficial, but its effects on these cancers are not well known. Join us as we talk to experts about some exciting research in this area which was discussed at the 2001 American Society of Hematology meeting.

Webcast Transcript

BRETT SCOTT: I'm Brett Scott in Orlando, Florida, where researchers have converged for the meeting of the American Society of Hematology. In recent years, the drug Rituxan has been a popular topic among attendants. It's a monoclonal antibody approved for several types of non-Hodgkin's lymphoma. But this year, many presentations are addressing its use in other types of NHL. I sat down with some experts to find out more.

Let's start with the basics, Dr. Press. What is Rituxan currently approved for?

OLIVER PRESS, MD: In this country, Rituxan is currently approved for the treatment of patients with relapsed indolent lymphomas including those with bulky disease and those which have recurred after initial therapy.

BRETT SCOTT: Dr. Marcus, there are many types of NHL. Can you briefly describe the main ones and the main stages?

ROBERT MARCUS, MD: Well, that's a complex question which I'll try and simplify as much as I can. The majority of patients will fall into two main categories either diffuse large cell lymphoma which pursues an aggressive course untreated or follicular indolent lymphoma which pursues a comparatively nonaggressive course. In terms of staging, the classic staging supply a single group of glands, more than one group of glands which would be stages I and II. The disease on both sides of the diaphragm would be stage III and disseminated disease would be stage IV. There are other prognostic measures which can be used to assess the outcome of the patient.

BRETT SCOTT: Are these less common types of NHL traditionally more difficult to treat?

ROBERT MARCUS, MD: Not necessarily. Not by definition. But a certain subtype such as mantle cell lymphoma which are often quite resistant to treatment, but other rarer types such as small lymphocytic lymphomas aren't necessarily more difficult.

Lymphomas arising from T cells obviously aren't amenable to antibody therapy but aren't necessarily as a consequence more difficult to treat with chemotherapy.

BRETT SCOTT: Dr. Press, why is Rituxan being used in these different types of NHL?

OLIVER PRESS, MD: It's being used predominantly in lymphomas that express a lot of the CD20 antigen. There is a molecular target on the surface of these lymphomas which the antibody binds to and fortunately, about 85% of lymphomas express this target very well. Those lymphomas which don't -- predominantly T cells lymphomas aren't really amenable to therapy to Rituxan as is mentioned.

And other diseases such as chronic lymphocytic leukemia which express a small amount of CD20 can be treated with Rituxan, but it hasn't been as dramatic a success there as it has been with the lymphomas that express more of the antigen.

BRETT SCOTT: Let's take a couple of specific examples. Dr. Marcus, can you comment on the use of monoclonal antibodies to treat aggressive NHL? What is the recent news being communicated this weekend?

ROBERT MARCUS, MD: Well, the important trial is the French Cooperative trial published by the GELA Group which has compared CHOP chemotherapy (which has been standard treatment for now over 25 years) with the addition of rituximab to CHOP chemotherapy. Response rates have been increased by at least 15% and the event-free survival almost by 20%. So this may -- may represent, if confirmed, the most significant advance in the treatment of diffuse large cell lymphoma for 20 years.

I should add that it probably only applies to the group in which the trial was done -- that is the over 60s. But it may have major implication for the overall therapy for diffuse large cell lymphoma.

BRETT SCOTT: Dr.