Thursday, May 28, 2015

New Drug Dramatically Improves Survival Rates in Hodgkin's Lymphoma Patients

MAYWOOD, Ill. - A new cancer drug with remarkably few side effects is dramatically improving survival rates in Hodgkin’s lymphoma patients who fail other treatments and are nearly out of options.

oyola University Medical Center oncologist Scott E. Smith, MD, PhD, presented survival data for the drug, brentuximab vedotin (Adcetris®), at the 17th Congress of the European Hematology Association. Smith is director of Loyola's Hematological Malignancies Research Program.

The multicenter study included 102 Hodgkin’s lymphoma patients who had relapsed after stem cell transplants. Tumors disappeared in 32 percent of patients and shrank by at least half in 40 percent of patients. An additional 21 percent of patients experienced some tumor shrinkage. Only 6 percent of patients had no response to the drug.

Sixty-five percent of patients were alive at 24 months, and in 25 percent of patients, the cancer had not progressed at all.

These are "encouraging results in patients with historically poor prognosis," researchers said.

Loyola patient Michelle Salerno had two failed stem cell transplants - one using her own cells and one using cells donated by her brother - and several rounds of chemotherapy before going on brentuximab vedotin. After three or four infusions, she stopped suffering chills, sweats, high fevers and itchy pain from head to toe. And she experienced almost none of the side effects common to chemotherapy.

"I kept my hair, and never felt like vomiting," she said. "You get the drug, you go home, you feel good."

The standard regimen is a 30-minute infusion every three weeks. A patient typically receives 16 doses over 48 weeks.

Loyola has administered about 500 doses to 60 patients. "A lot of our patients are doing great on this regimen," Smith said.

Hodgkin’s lymphoma is a cancer of the immune system. Most patients can be cured with chemotherapy or radiation, especially when the disease is diagnosed in early stages. However, if initial treatment fails, the patient may require an autologous stem cell transplant. This procedure uses the patient's own stem cells to replace immune system cells that are destroyed by high-dose chemotherapy or radiation.

About 50 percent of patients who undergo autologous stem cell transplants relapse. Among patients who relapse, only 10 percent survive.

The Food and Drug Administration last year approved brentuximab vedotin for patients who have either failed an autologous stem cell transplant, are ineligible for a stem cell transplant or have failed two multidrug chemotherapy regimens.
Brentuximab vedotin is an antibody attached to a powerful chemotherapy drug. The antibody acts like a homing signal, bringing the chemo drug to lymphoma cells.

"Brentuximab represents a very interesting new concept in the fight against cancer," said oncologist Tulio Rodriguez, MD, who treats Salerno and is medical director of Loyola's Bone Marrow Transplantation Program. "It delivers powerful chemotherapy right where it needs to be - into the cancer cell."

Cancer patients frequently are debilitated not only by their cancer, but also by chemotherapy treatments. Targeted drugs such as brentuximab can spare patients from the harmful effects of traditional chemotherapy, Rodriguez said.
The study found that side effects from brentuximab were generally mild. Only 9 percent of patients suffered severe peripheral neuropathy, 2 percent had extreme fatigue and 1 percent had severe diarrhea.

Salerno said the only significant side effect she experienced was mild neuropathy, which went away when the dose was lowered.

Salerno, 43, has been battling Hodgkin’s lymphoma for 10 years. Although she is not cured, she said, "I feel great and have a good quality of life."

Salerno, who lives in Lombard, said her treatments inspired her to start a business. She markets the Joey Pouch™ - a small, soft pouch designed to comfortably hold the lumens of a central venous catheter so a patient can be more comfortable in daily activities or while sleeping. It is worn around the neck, next to the chest. The Joey Pouch is named after Salerno's brother, Joey, who donated stem cells used in one of her transplants.

Rodriguez said he feels immense satisfaction when he goes over CT scans with Salerno to show her how her disease is heading back into remission. But he cautioned that brentuximab, like all drugs, has potential toxicities. "Patients should talk with their doctors about the pros and cons of taking this drug and discuss whether it is best for them," Rodriguez said.

About Loyola University Health System

Loyola University Health System (LUHS) is part of Trinity Health. Based in the western suburbs of Chicago, LUHS is a quaternary care system with a 61-acre main medical center campus, the 36-acre Gottlieb Memorial Hospital campus and more than 30 primary and specialty care facilities in Cook, Will and DuPage counties. Loyola University Medical Center’s campus is conveniently located in Maywood, 13 miles west of Chicago’s Loop and 8 miles east of Oak Brook, Ill. At the heart of the medical center campus is a 559-licensed-bed hospital that houses a Level 1 Trauma Center, a Burn Center and the Ronald McDonald® Children's Hospital of Loyola University Medical Center. Also on campus are the Cardinal Bernardin Cancer Center, Loyola Outpatient Center, Center for Heart & Vascular Medicine and Loyola Oral Health Center as well as Loyola University Chicago Stritch School of Medicine, Loyola University Chicago Marcella Niehoff School of Nursing and the Loyola Center for Fitness. Loyola's Gottlieb campus in Melrose Park includes the 255-licensed-bed community hospital, the Professional Office Building housing 150 private practice clinics, the Adult Day Care, the Gottlieb Center for Fitness, Loyola Center for Metabolic Surgery and Bariatric Care and the Loyola Cancer Care & Research at the Marjorie G. Weinberg Cancer Center at Melrose Park.

Trinity Health is a national Catholic health system with an enduring legacy and a steadfast mission to be a transforming and healing presence within the communities we serve. Trinity is committed to being a people-centered health care system that enables better health, better care and lower costs. Trinity Health has 88 hospitals and hundreds of continuing care facilities, home care agencies and outpatient centers in 21 states and 119,000 employees.