After three decades of quiet on the research front, there are several new agents being studied to treat Hodgkin’s lymphoma, a disease that affects more than 8,000 Americans a year. The standard treatment for Hodgkin’s lymphoma is a four-drug chemotherapy known as ABVD. Anas Younes, a professor and lymphoma expert at M. D. Anderson Cancer Center, says that while the success rate for ABVD is over 80%, the long-term effects of this highly toxic therapy have a negative impact on overall survival in a patient population whose median age is 20 years:
The cure rate is usually higher than survival because the patients who are cured still die of complications of the curative therapy, including second cancers, heart disease, lung disease and so forth. So not only do we need more effective treatment, we need safer treatment for these patients.
Hodgkin’s patients who don’t respond to ABVD, or to secondary treatments of chemotherapy and stem cell transplantation often have few therapies left to try — until now. Dr. Younes and his team at M. D. Anderson as well as others around the country are conducting clinical trials using novel targeted therapies. These drugs are designed to attack cancer cells in one of two ways: either by using small molecules to block specific pathways that cells use to survive and multiply, or by using antibodies that deliver cancer-killing agents through receptors on the cell surface.
Targeted therapies are showing early promise for patients such as 38-year old Bryan Crowell from Atlanta, Georgia. Crowell was diagnosed with Hodgkin’s lymphoma in January 2005 and received ABVD and follow-up radiation. He relapsed six months later and underwent high-dose chemotherapy and a stem cell transplant. Seven months later, the lymphoma was back again. Crowell then enrolled in an M. D. Anderson clinical trial for SGN-35, a monoclonal antibody combined with a highly effective cancer-killing agent. He says the difference between treatments is night and day:
The side effects are absolutely minimal. Having experienced chemotherapy, the “shotgun approach”, and contrast that with the “laser approach” of what we’re doing now and hopefully what cancer treatment will be in the next 15 to 20 years is amazing. I have lived both now; I’ve had the chemo and I’ve had this and this is incredible.
Dr. Younes says that as new pathways are discovered, targeted therapies, which Bryan Crowell refers to as the “laser approach”, may eventually replace standard chemotherapy. Targeted therapies, he says, are given either in pill form of by IV injection:
You really have to explore other resistance pathways that you can block with small molecules. I think that’s one of the advantages. So now you’re targeting different resistance pathways to make the cancer cells more sensitive. The other advantage is of course reducing toxicity. Chemotherapy, I think 10 years from now will be seen as a barbaric way of treating cancer patients.
For more information on targeted therapies for Hodgkin’s lymphoma, e-mail Dr. Younes at email@example.com
For Conquest, I’m Lisa Garvin.
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