Lymphoma

Lymphoma

Lymphoma, or cancer of the lymphatic cells of the immune system, was one of the first types of cancer to be considered curable. In the 1970s, the success of combination chemotherapy in curing patients with Hodgkin’s lymphoma helped inspire the nation's new investments in cancer research. Since then, continued advances have led to high cure rates for some forms of lymphoma, while helping to reduce side effects and improve patients' lives.

Despite these advances, lymphoma is not always curable and more than 20,000 Americans still die from the disease annually. However, researchers are gaining a deeper understanding of the biology of lymphoma, with more than 60 unique cancer subtypes now known. This information is guiding the search for new treatments and helping to determine which patients need more aggressive therapy.
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2019

First FDA-Approved Combination and Chemotherapy-Free Treatment Regimen Improves Progression-Free Survival for Patients With Slow-Growing Forms of Non-Hodgkin Lymphoma

First FDA-Approved Combination and Chemotherapy-Free Treatment Regimen Improves Progression-Free Survival for Patients With Slow-Growing Forms of Non-Hodgkin Lymphoma

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Follicular lymphoma and marginal zone lymphoma are the most common types of non-Hodgkin lymphoma (NHL). Lenalidomide plus rituximab is the first FDA-approved combination treatment regimen for patients with these lymphomas that does not include chemotherapy. The combination’s 2019 FDA approval was based on the results of a phase-III randomized trial of the regimen conducted in patients with relapsed and/or refractory follicular or marginal zone lymphoma. Compared with placebo plus rituximab, the lenalidomide/rituximab combination roughly halved the risk of disease progression, with median progression-free survival of 39.4 months versus 14.1 months with placebo.

More Information: 

J Clin Oncol 2019;37:1188-99

2015

Immunotherapy helps patients with treatment-resistant Hodgkin lymphoma

Immunotherapy helps patients with treatment-resistant Hodgkin lymphoma

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2015-2017

A growing body of research shows that for patients with Hodgkin lymphoma that do not respond to standard treatment, including autologous stem cell transplantation, immunotherapy with PD-1 inhibitors can have significant benefits. Clinical trials suggest that treatment with the PD-1 inhibitors nivolumab (Opdivo) or pembrolizumab (Keytruda) can lead to remissions in patients who had received many previous cancer treatments, leading the FDA to grant accelerated approval to both drugs for this indication in 2016 and 2017, respectively.  

More Information: 

FDA; Nivolumab (Opdivo) for Hodgkin Lymphoma
Lancet Oncology 2016;17(9): 1283-94
JCO 2016; 34(31): 3733-3739
N Engl J Med. 2015; 372(4):311-319
FDA; Pembrolizumab (KEYTRUDA) for Classical Hodgkin Lymphoma

2013

Ibrutinib approved for two hard-to-treat blood cancers

Ibrutinib approved for two hard-to-treat blood cancers

The FDA approves ibrutinib (Imbruvica) for patients with mantle cell lymphoma or chronic lymphocytic leukemia that progresses despite other standard therapies.  The approvals are driven by clinical studies showing that the drug causes tumor shrinkage in a substantial majority of patients with these treatment-resistant cancers.  Ibrutinib—which is taken orally—targets a critical enzyme involved in the growth and survival of these cancers, and in many cases, offers patients a treatment option that causes fewer side effects than existing therapies.

More Information: 

New England Journal of Medicine
New England Journal of Medicine
FDA News Release Nov. 13, 2013
FDA News Release Feb. 12, 2014

2008

First drug approved specifically for T-cell lymphoma treatment

First drug approved specifically for T-cell lymphoma treatment

A study shows that the new targeted anticancer drug pralatrexate (Folotyn) shrank tumors in nearly one-third of patients with peripheral T-cell lymphoma that persisted or returned after conventional therapy. Tumors disappeared completely in more than 10 percent of patients in the study. In 2009, the FDA grants accelerated approval for pralatrexate for peripheral T-cell lymphoma that has relapsed or has not responded well to other forms of chemotherapy. This is the first drug to be specifically approved to treat T-cell lymphoma, and this accomplishment reflects a movement toward increased clinical research coordination among lymphoma researchers in the U.S. and worldwide to identify new therapies for this rare but often aggressive disease.

More Information: 

Clinical Cancer Research 2010; 16(20): 4921–4927

2007

PET scanning helps guide lymphoma treatment

PET scanning helps guide lymphoma treatment

Periodic PET (positron emission tomography) scanning is shown to be useful in predicting treatment outcomes for patients with advanced Hodgkin lymphoma. This new ability to accurately and non-invasively monitor a patient's cancer, and their response to therapy, leads to increased research on how to spare patients from unnecessary treatment, while maintaining effectiveness.

More Information: 

JCO 2007; 25(24): 3746-3752

2005

Bortezomib shrinks tumors in mantle cell lymphoma

Bortezomib shrinks tumors in mantle cell lymphoma

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Two studies show that the drug bortezomib (Velcade) shrinks tumors in nearly half of patients with mantle cell lymphoma, one of the rarest forms of non-Hodgkin lymphoma. The drug is approved the next year for patients who have relapsed after prior treatment. Bortezomib blocks the proteasome, a protein complex inside the cell that destroys proteins that are no longer needed and cleanses the cell of abnormal proteins. Researchers continue to explore other drugs that target the proteasome.

More Information: 

JCO 2005; 23(4): 667-675
JCO 2005; 23(4): 676-684

2002

Radioimmunotherapy introduced to treat lymphoma

Radioimmunotherapy introduced to treat lymphoma

This new therapeutic approach becomes available to patients with the FDA approval of the drug ibritumomab tiuxetan (Zevalin). The drug acts as a "smart bomb" against the tumor by combining a radioactive material with a protein that locates and binds to a select receptor on cancer cells called CD-20. The radioactive material kills the cells with which it comes in contact, while sparing the healthy surrounding tissue. In 2003, a similar drug called tositumomab (Bexxar) is approved for the same use.

More Information: 

JCO 2002; 20(10): 2453-2463
JCO 2002; 20(15): 3262-3269
JCO 2005; 23(30): 7565-7573
Adding rituximab to "CHOP" chemotherapy boosts survival

Adding rituximab to "CHOP" chemotherapy boosts survival

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The targeted drug rituximab (Rituxan), when added to standard CHOP chemotherapy (cyclophosphamide, doxorubicin, vincristine and prednisone), is shown to boost survival for older patients with diffuse B-cell lymphoma. Subsequent trials confirm the results in patients of all ages, and the "R-CHOP" combination soon becomes standard treatment for this type of non-Hodgkin lymphoma.

More Information: 

Cancer.Net; Lymphoma - Non-Hodgkin: Treatment Options
N Engl J Med 2002; 346: 235-242
JCO 2006; 24(19) 3121-3127

2001

Scientists discover that common type of lymphoma is two distinct diseases

Scientists discover that common type of lymphoma is two distinct diseases

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Research shows that diffuse large B-cell lymphoma – the most common form of non-Hodgkin lymphoma – is actually two distinct diseases, each with its own genetic profile. The finding explains why only 40 percent of patients with B-cell lymphoma are cured with current treatments, and leads to a renewed search for treatments that can be tailored to each subtype.

More Information: 

Cancer.Net; Lymphoma - Non-Hodgkin: Subtypes
Nature 2000; 403: 503-511

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