Non-Hodgkin's Lymphoma - Other Treatments

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Radioimmunotherapies

Some newer MAbs are used to treat NHL by attaching radioactive molecules to them. When the drug is injected, the monoclonal antibody targets an antigen (protein) on the surface of the tumor. The radioisotope is then delivered directly into the tumor where it kills the cancer. Ibritumomab and tositumomab both target the CD-20 antigen. Treatment with these drugs takes about 7 - 9 days to complete, compared to several months for traditional chemotherapy treatments.

• Ibritumomab ((Zevalin) is approved for patients with relapsed or refractory low-grade, follicular or transformed B-cell NHL, and for patients with follicular NHL who have not responded to rituximab (Rituxan). It has been safely used for patients with advanced NHL who have had stem cell transplantation.
• Tositumomab (Bexxar) combines the monoclonal antibody tositumomab with the radioisotope I-131. Tositumomab is approved for treatment of relapsed or refractory low-grade, follicular, or transformed B-cell NHL.

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Overall response rates of over 50% have been reported with these drugs, with up to 30% having no evidence of cancer for a period of time.

In general, these drugs cause fewer side effects than traditional chemotherapy. However, serious complications may include skin infections, severe allergic reactions, and temporary lowering of blood counts. Due to the radioisotope component, these drugs are also more difficult to administer than rituximab. They tend to be used if patients do not respond to rituximab.

Other Biologic Drugs

Proteasome Inhibitors. Bortezomib (Velcade) is approved for treatment of mantle cell lymphoma in patients who have received at least one prior therapy.

Investigational Biologic Therapies

Vaccines. Although still experimental, lymphoma vaccines are used to treat -- not prevent -- cancer. They are part of an immunotherapy approach called personalized medicine; each vaccine is individually tailored to the genetic composition of the patient’s tumor. The vaccine is usually given a few months after a patient receives chemotherapy. The BiovaxID vaccine is in late-stage clinical trials.

Review Date: 01/27/2011
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).