Study identifies promising treatment for aggressive lymphoma

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BlankStudy identifies promising treatment for aggressive lymphoma

CHICAGO -- New research illustrates that some patients with transformed lymphoma

showed " remarkable " response to lenalidomide, an oral drug with few side

effects.

The international study, involving 24 medical centers in the United States and

Europe, will be presented at the American Society of Clinical Oncology

(http://www.asco.org/) annual meeting June 4-8, 2010, in Chicago.

Forty-five percent of patients with transformed lymphoma treated with

lenalidomide responded positively to this immunomodulatory medication, which

kills lymphoma cells by activating the body's natural killer cells and by

interrupting cancer cell signaling that leads to cell death. Of those patients,

21 percent showed complete remission, some for more than a year.

Transformed lymphoma is an aggressive form of blood cancer. With current

therapies, patients have a median survival rate of 1.7 years. In comparison,

patients with indolent or slow-growing lymphoma can live 10 to 20 years with the

disease. However, over the course of a decade, about 30 percent of those with

indolent lymphoma develop transformed lymphoma.

" The study results show a remarkable response rate for transformed lymphoma

patients who have a very poor prognosis, " says Craig er, M.D.

(http://www.mayoclinic.org/bio/10010343.html), Mayo Clinic hematologist

(http://www.mayoclinic.org/hematology-oncology-sct/) and principal investigator

for the phase II study at Mayo Clinic's Arizona

(http://www.mayoclinic.org/arizona/) campus. Phase II studies typically include

no more than 300 patients and are designed to evaluate the effectiveness of a

specific therapy.

The study included 217 patients with aggressive lymphoma. Of those, 33 had

transformed lymphoma and were treated with lenalidomide. These patients ranged

in age from 42 to 84. More than half had stage IV disease, where the lymphoma

has spread to multiple sites or organs. All patients had been treated with

chemotherapy and some with stem cell transplant to curtail the cancer. The

median number of previous treatments was four and ranged up to 12.

Patients took lenalidomide pills (25 mg) daily for 21 days. For seven days, no

medication was given. The medication continued until signs of cancer

progression. Overall, 45 percent of patients responded positively to the

therapy, but results varied by the particular type of transformed lymphoma.

For transformed follicular lymphoma, the most common form of the illness, 13 of

the 23 patients (57 percent) in this subgroup responded positively to

lenalidomide. Ten patients with other types of transformed lymphoma did not

respond. They included transformed chronic lymphocytic leukemia, small

lymphocytic lymphoma and others.

Dr. er notes that while the number of patients treated with lenalidomide was

small, the results are promising because of the response rate, the length of the

response, and the simplicity of treatment. In patients who responded, the

positive effect of lenalidomide was seen for a median of nearly 13 months.

Compared to chemotherapy drugs, lenalidomide is easy to administer and is well

tolerated. " Its appeal is that it's not toxic to the patient, " he says. Side

effects were considered mild and included low white blood cell counts.

Lenalidomide is approved by the U.S. Food and Drug Administration to treat

multiple myeloma and certain types of myelodysplastic syndrome. Mayo Clinic

researchers and others have been studying its potential as a lymphoma treatment

for about two years. Further studies are needed to confirm its role in treating

patients with transformed lymphoma.