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.

Lymphoma Vaccine Increases Disease-Free Survival in Clinical Trial

By Peter Martin, MD

Researchers at The University of Texas MD Anderson Cancer Center report that a follicular lymphoma vaccine uniquely tailored for each patient extended disease-free survival by 14 months. The results were recently published online in the Journal of Clinical Oncology. Click here to read the published abstract.

To make the vaccine, unique proteins from each patient’s tumor were isolated and combined with a delivery agent and a growth factor. This mixture was then injected back into the patient.

Earlier studies have shown that lymphoma vaccines are able to induce anti-tumor immune responses in some patients. Importantly, patients that produced an immune response seemed to have longer remissions than those that did not. However, when the vaccines were tested in phase 3 studies, the results were not as impressive. Two phase 3 studies comparing vaccines vs no vaccine in patients with follicular lymphoma have been reported. The MD Anderson study is the first phase 3 study to demonstrate a benefit for patients receiving vaccine.

Notably, there were a few important differences between the most recent study and the two prior studies. Continue reading “Lymphoma Vaccine Increases Disease-Free Survival in Clinical Trial”

Lymphoma in the News: No Benefit to Rituximab Maintenance Following Autologous Stem Cell Transplantation in Patients with Relapsed DLBCL

By Peter Martin, MD

Patients with diffuse large B-cell lymphoma (DLBCL) that has relapsed following first-line chemotherapy are typically offered second-line chemotherapy followed by autologous stem cell transplantation (bone marrow transplantation using the patient’s own stem cells).

The CORAL study, a recently completed international phase 3 trial, evaluated whether rituximab following the transplant procedure could improve patient outcomes. The results of the study were recently presented at the American Society of Clinical Oncology (ASCO) annual meeting.

Following second-line chemotherapy (R-ICE or R-DHAP) and stem cell transplant, 242 patients were randomized to receive rituximab given every two months for one year or observation. By four years, there was no difference in rate of progression or survival between the two groups. Interestingly, women that received rituximab maintenance did considerably better than men that received rituximab maintenance while there was no difference in outcomes between the two genders in the observation group.

Based on these results, there does not appear to be an advantage to rituximab maintenance following stem cell transplantation for DLBCL.

Click here to read the abstract of the CORAL study results as presented at the ASCO annual meeting.

Lymphoma in the News: R-CHOP 21 Remains Standard of Care for Diffuse Large B-Cell Lymphoma

By Peter Martin, MD

Several studies have demonstrated that rituximab (R) added to CHOP chemotherapy (cyclophosphamide, doxorubicin, vincristine, prednisone) can improve the outcomes of patients with diffuse large B-cell lymphoma (DLBLC). Nonetheless, there remains room for improvement.

A German study from the pre-rituximab era demonstrated that giving CHOP chemotherapy every two weeks (i.e., CHOP-14) was better than given CHOP every three weeks (i.e., CHOP-21) in patients older than 60 years of age. This type of therapy is also referred to as “dose-dense” therapy, and it is attractive because it theoretically allows less time for cancer cells to grow between chemotherapy cycles. The question of whether CHOP-14 would remain superior to CHOP-21 even after the addition of rituximab is the subject of two ongoing phase 3 clinical trials, one in France and one in the United Kingdom (UK). Dr. David Cunningham presented the results of the latter trial at the recent meeting of the American Society of Clinical Oncology (ASCO) in Chicago. After a median follow-up of about three years, there was no difference in survival between patients treated with R-CHOP-14 or R-CHOP-21. Click here to see the study abstract. These results are consistent with preliminary results from the French study presented in 2010 and confirm that R-CHOP 21 should remain the standard of care for most patients with DLBCL.

At Weill Cornell Medical Center, we believe that improvements in patient outcomes are likely to come from the addition of  newer, targeted drugs to R-CHOP rather than increasing the dose or density of  older chemotherapy regimens.