Tag: chemotherapy

New Treatment Combination Poses Potential Way to Combat Chemo-Resistant DLBCL

Each year, roughly 20,000 Americans are diagnosed with diffuse large B-cell lymphoma (DLBCL), an aggressive cancer of abnormal B-cells. Most people with DLBCL are cured with the standard chemotherapy regimen rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP), but 30-40 percent of cases are resistant to chemotherapy for reasons that may be related to the way that genes are regulated within the cancer cells.

Prior WCM laboratory research demonstrated that certain genes within chemotherapy-resistant DLBCL cells are often inappropriately turned off and that long-term exposure to low doses of oral hypomethylating agent azacitidine (also known as CC-486) can turn those genes back on, thereby re-sensitizing the cells to chemotherapy.

Lymphoma Program chief Dr. Peter Martin, Dr. Leandro Cerchietti, Dr. John P. Leonard, Dr. Maria Revuelta and Dr. ldefonso Ismael Rodriguez-Rivera, and colleagues from around the country, set out to test a novel therapeutic alternative for these chemo-resistant cases with a phase I, open-label, multicenter trial of oral azacitidine plus R-CHOP in people with high-risk, previously untreated DLBCL, grade 3B follicular lymphoma (FL), or transformed lymphoma. The trial was conducted in collaboration with Alliance Foundation Trials (AFT), a research organization that develops cancer clinical trials with pharmaceutical companies, scientific investigators and the Alliance for Clinical Trials in Oncology (ACTO) institutional member network.

Patients in the trial received CC-486 for seven days prior to R-CHOP initiation, then for 14 days prior to each of five following R-CHOP cycles. The research team found that the combination of CC-486 plus R-CHOP was safe and well tolerated, and that it produced a higher-than-anticipated complete response (CR) rate, or disappearance of signs of cancer, exceeding 85 percent. Dr. Cerchietti’s lab also identified key changes in genes and gene expression consistent with the anticipated CC-486 effect. Dr. Martin presented the team’s findings at the American Society of Hematology Annual Meeting and Exposition on December 9, 2017, in Atlanta, GA.

Weill Cornell Medicine

“We are at an exciting moment in time: CC-486 is emerging simultaneously with a peak in collaborative efforts between scientists, physicians and patients,” said Dr. Martin. “We are working day and night to move this concept forward, including the possible opening of randomized trials.”

Chemo-Free Follicular Lymphoma Treatment Regimen Shows Promise in Phase II Clinical Trial

CaptureThe combination of lenalidomide and rituximab may represent a reasonable alternative to chemotherapy for some people with previously untreated follicular lymphoma (FL), according to a study led by Dr. Peter Martin, chief of the Weill Cornell Medicine and NewYork-Presbyterian Hospital (WCM/NYP) Lymphoma Program.

Dr. Martin collaborated with the Lymphoma Program’s Drs. Jia Ruan and John Leonard, along with experts from academic medical centers across the country, to evaluate the non-chemotherapy drug combination in a phase II trial known as CALGB 50803, the results of which were recently published in the Annals of Oncology. The formalized collaboration was made possible by the Alliance for Clinical Trials in Oncology, a cooperative group sponsored by the National Cancer Institute (NCI).

Lenalidomide plus rituximab was administered over twelve 28-day cycles to 65 adults with previously untreated follicular lymphoma. Seventy-two percent of patients achieved a complete response. At five years, the overall survival rate was 100 percent, and 70 percent of patients remained free from disease progression. Rates are comparable with those typically produced by standard chemotherapy.

The study also demonstrated low rates of hematologic toxicity, such as neutropenia (low white blood cell count), lymphopenia (low lymphocyte levels) and thrombocytopenia (low platelet count), but low-grade side effects like fatigue, constipation, diarrhea and rash were commonly reported.

The results of the CALGB 50803 study do not definitively establish whether lenalidomide-rituximab is more or less toxic or more or less effective than a standard chemotherapy regimen; such insights will be clearer following completion of the randomized phase III RELEVANCE trial, which compares lenalidomide-rituximab to chemotherapy plus rituximab.

Optimal use of chemotherapy requires a careful balance of anti-tumor activity with tolerability. WCM/NYP is proud to be a leader in the discovery and development of therapies that are both active against cancer and well tolerated.

A Reflection on National Cancer Survivor Day: “I’m Cancer-Free, But I Don’t Like the Word ‘Survivor’”

By Katie DeMasi

Today, June 4th, is National Cancer Survivor Day. Personally, I’m not totally in love with the word “survivor.” Maybe it’s because I’m new to this whole thing. It’s only been a little less than two months since I was told I’m cancer free. When I think about survivors, I think about plane crashes or that show on TV. I think about luck. I didn’t beat cancer because I was lucky or because no one decided to vote me off the island. I beat cancer with the help of my healthcare team, especially everyone at Weill Cornell Medicine and NewYork-Presbyterian Hospital, modern day medicine, and positivity.

KatieDeMasi_lastchemo
Here I am on my last day of chemotherapy.

This is all just my opinion, and maybe as I get older and time goes on, I will understand survivorship in the face of cancer. Nonetheless, today is a day to commemorate those who have won their battles and to remember those who aren’t with us. It is a day of not only celebration, but also reflection.

I often think about what my life was supposed to be before I was diagnosed with Hodgkin lymphoma last August. I was supposed to be starting a job as a new nurse in New York City. I was supposed to move out of my childhood home. I was supposed to be living my life like any normal post-graduate. But to be honest, I’m kind of sick of talking about that. I’m more interested in what my life is and will be. I like to think about how my experience with cancer has changed me as a person. I think about what I have overcome and just how I did it.

I have learned the true meaning of the expression “YOLO” (You only live once.) and have included the word “yes” a lot more in my day-to-day life. And not just in the instances where it’s like, “Do you want to get ice cream?” or “Do you want to leave work early?” because those answers always have been and always will be “yes.”

I’m talking more about attitude and experiences. I can say with my whole heart that I have become a more positive person because of what I’ve been through, which might sound weird to some people. Why would something that was pretty awful cause me to have a better outlook on life? Well, it’s because I’m still here. Duh.

Chemo is bad. It is not fun. It is the enemy. But you know what they say: “Keep your friends close and your enemies closer.” So instead of complaining about having to wake up early to sit in traffic just to get to the hospital, and then get chemo dumped into my body, and then feel like a zombie for the next couple of days, I said “yes.” Yes, I can do this. Yes, I can get through this. Yes, I will take that Ativan before I leave the hospital so I can sleep in the car on the way home.

And now that chemo is done and has left me with a taste aversion to cranberry turkey wraps (I know, specific, but I ate one while getting chemo once and just the thought of it is making me gag.), I have carried over my “yes” attitude into my every day life.

I love sitting on the couch in my sweatpants binge-watching Netflix as much as the next girl, but there is a lot to do and see in this world. In this life. I’m not saying I plan on never working again and travelling the world (even though if I won the lottery today, I would probably be on a plane to somewhere new tomorrow); I’m talking about taking advantage of a beautiful day. Spending it outside instead of being cooped up all day. Doing something I’ve never done before, like going to a music festival or paddle boarding. Trying a new menu item at a restaurant I’ve been to a million times. Trying a new restaurant all together. Meeting new people. Spending time with family and friends and really being present.

KatieDeMasi_hotdog
Here I am outside of NYP after I got my clear scan results, eating my first hot dog in six months. Again, it’s the little things.

It’s the little things that I am saying yes to now. Things that maybe I would have ignored or pushed off before. I have stopped thinking about what the plan for my life was and started to think about what the plan is. Life threw me lemons even though I planned on making orange juice. So what did I do? I took those lemons and made a lot of lemonade during chemo because it really seemed to help with the nausea.

I can wish I never had cancer all I want, but that’s not going to change the fact that I had it. So, I have changed my attitude and learned to appreciate what I have now, turkey wrap taste aversion, lemons, and all.