Will Targeted Therapies Work ... Video Transcript

Participants

, Joseph M. Connors MD, FRCPC, Kanti Rai MD, Brett Scott

Summary

Initially approved for specific types of non-Hodgkin's lymphoma, the monoclonal antibody Rituxan is now being used by to treat Chronic Lymphocytic Leukemia or CLL. At a recent medical conference, experts discussed the success of this stategy, as well as the use of other targeted therapies for CLL. Join Dr. Kanti Rai and Dr. Joseph Connors as they discuss the latest findings.

Webcast Transcript

BRET SCOTT: I'm Bret Scott in Orlando, Florida, site of this year's meeting of the American Society of Hematology.

Monoclonal antibody therapies that directly attack cancer cells are a hot topic in medicine. At this year's meeting, several research presentations focused on the use of these therapies for chronic lymphocytic leukemia, or CLL. I sat down with some of the experts to learn more about this development.

Dr. Rai, is Rituxan improving on traditional treatments for CLL? And if so, how?

KANTI RAI, MD: Rituxan is indeed improving on traditional treatment, if one considers today in year 2001 that fludarabine is the standard treatment for CLL. We get just so much of what we call "remission rate" with fludarabine. And we find that when we add Rituxan to fludarabine, the remission rate is practically doubled.

BRET SCOTT: Dr. Connors, will Rituxan be used differently to treat CLL compared with NHL? I'm thinking schedule and dose here.

JOSEPH M. CONNORS, MD, FRCPC: I would expect that it will. The schedule that works for a tumor-like lymphoma, where the cells are settled in one place in the body may well be different from the schedule that works best for a leukemia, where the malignant cells circulate around in the bloodstream. So I think we may expect different doses, different schedules and even different lengths or durations of treatment.

BRET SCOTT: Dr. Rai, any thoughts?

KANTI RAI, MD: Rituxan in lymphoma is given once a week for several weeks. Four weeks, six weeks, eight weeks. And it is quite effective in those patients.

But when you give Rituxan in the same manner to a person with CLL, it just does not have much activity. However, when you give Rituxan in combination with other standard chemotherapy drugs and, instead of giving it on a weekly basis, you give it once a month, the combination is a blockbuster.

BRET SCOTT: Dr. Rai, several treatment options for CLL using Rituxan were discussed at this meeting. Can you briefly explain the main options?

KANTI RAI, MD: Well, let me explain to you that the introduction of Rituxan in CLL is relatively recent happening. So we cannot claim that we know everything as to how to use Rituxan in the most effective manner for our patients with CLL. Therefore there are lots of combinations and permutations being tried with an objective of finding out what works best for what group of patients.

BRET SCOTT: Dr. Connors, how will Rituxan be used in treating younger patients versus older patients with CLL?

JOSEPH M. CONNORS, MD, FRCPC: I'm going to turn that question around a little bit, because one of the real virtues of antibody treatment -- monoclonal antibody treatment is the ability to treat older patients with it, when the toxic effects of other kinds of treatments may prevent you from doing so. So I think that we will find that rituximab is used in older patients that we might not have been able to otherwise treat well.

But to return to younger patients, I expect it to be combined with other still fairly intensive treatments in attempts to get rid of all of the leukemia completely. But that is moving to an era where we actually attempt to cure the disease, as opposed to control it as we might have in the past.

BRET SCOTT: Dr. Connors, Campath is another monoclonal used to treat CLL. How does it differ from Rituxan and how is it used?

JOSEPH M. CONNORS, MD, FRCPC: The difference is the target. The monoclonal antibody in question is always directed at a specific surface characteristic or a small bump as I describe it on the surface of the cells.