Author: lymphomaprogram

Located on the Upper East Side of New York City, the Lymphoma Program at Weill Cornell Medical College/NewYork Presbyterian Hospital is internationally recognized for our efforts to enable patients with non-Hodgkin lymphoma, Hodgkin disease and related disorders to have the best possible clinical outcome, including cure when possible.

Lugano Conference: Maintenance Rituximab Improves Progression Free Survival in Mantle Cell Lymphoma

Weill Cornell’s Dr. Rebecca Elstrom attended the 11th International Conference on Malignant Lymphoma in Lugano, Switzerland and provides this update:

Maintenance rituximab improves progression free survival in patients with mantle cell lymphoma when given after rituximab in combination with chemotherapy. These results were reported at the 11th International Conference on Malignant Lymphoma this week. Dr. Kluin-Nelemans and colleagues compared R-CHOP chemoimmunotherapy to R-fludarabine/cyclophosphamide as first line treatment of patients over 60 with mantle cell lymphoma, finding R-CHOP to be superior in this group of patients. A second randomization, to rituximab maintenance or interferon, showed that the extended administration of rituximab prolonged the time to lymphoma progression by more than two years on average.

Although maintenance rituximab has been shown to prolong remissions in patients with follicular lymphoma after rituximab plus chemotherapy, this is the first time that rituximab has been shown to have a similar effect in mantle cell lymphoma, a type of lymphoma in which remissions tend to be shorter and more difficult to treat.

Lugano Conference: Rituximab + Lenalidomide Prolonged Remission in Mantle Cell Lymphoma

Weill Cornell’s Dr. Rebecca Elstrom is attending the 11th International Conference on Malignant Lymphoma in Lugano, Switzerland and provides this update:

Researchers from MD Anderson Cancer Center reported results of a study of the combination of rituximab and lenalidomide in relapsed and refractory mantle cell lymphoma (MCL) at the 11th International Conference on Malignant Lymphoma on Thursday, June 16. The study included 52 patients treated on a combined phase 1/phase II study. The researchers found that more than half (57.8%) of patients responded to treatment, and most responses lasted for at least 18 months.  The combination was very well tolerated, with few bothersome side effects.  These results are striking for this group of patients, especially as many had not responded to previous therapy.

The combination of rituximab and lenalidomide is of interest because both drugs work, at least in part, by promoting the patient’s immune system to destroy lymphoma cells, and laboratory studies have suggested that each drug may make the other work better.  In addition to mantle cell lymphoma, this combination is being investigated in other B-cell lymphoma subtypes.

Weill Cornell Medical Center is conducting a study of the combination of rituximab and lenalidomide in follicular lymphoma. The study is sponsored by The Cancer and Leukemia Group B (CALGB) and is being led at Weill Cornell  by Dr. Elstrom. (Update: this study is closed to enrollment.)

Weill Cornell Research: Epigenetic Priming to Improve Chemotherapy Response Can Be Safely Administered in AML Patients

By Rebecca Elstrom, MD

Researchers at Weill Cornell Medical Center have demonstrated that epigenetic priming of standard induction chemotherapy can be safely administered in an attempt to improve the response rate of patients with acute myeloid leukemia (AML).

Epigenetics refers to reversible alterations to DNA or DNA-associated proteins which affect gene expression, and epigenetic processes have been shown by researchers at WCMC and others to be disrupted in many types of cancer.  Drugs currently available and approved by the FDA can target these abnormal epigenetic changes, and pretreatment with these drugs (epigenetic priming) might make cancer cells more vulnerable to chemotherapy.

In the research study recently published in Blood, the Journal of the of the American Society of Hematology, patients were treated with the drug decitabine prior to a standard induction of chemotherapy. The toxicity, or side effects, of chemotherapy plus decitabine was similar to that of chemotherapy alone. Although the primary purpose of the study was to evaluate the safety of adding decitabine, the epigenetic primer, to standard chemotherapy, the overall complete response rate was 83%, suggesting that decitabine-primed induction should be explored as a complementary approach to standard chemotherapy. Click here to read the published research paper.

There is the possibility that the approach of epigenetic priming could translate into therapeutic advantages in other forms of cancers.  Many types of cancers have been shown to develop with abnormal epigenetic changes, including lymphoma.  The lymphoma research group at Weill Cornell Medical Center is  also exploring the strategy of epigenetic priming in patients with newly diagnosed aggressive B cell  non-Hodgkin’s lymphoma, in hopes of improving on results of standard chemotherapy. Click here to read more about this study. Click here to read the clinical and research profile of Rebecca Elstrom, MD, the physician leading the lymphoma trial.