Immunotherapy of NHL, An Overview

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Part of a free, full article that is an update of

where we are in CLL and NHL. The full text article is

available at the address below.

Immunotherapy of Non-Hodgkin's Lymphomas

Oliver W. Press, P. Leonard, Bertrand Coiffier,

Levy and Timmerman

Abstract

Recent years have witnessed the development of a

variety of promising immunotherapies for treating

patients with non-Hodgkin's lymphomas.

Foremost among these advances is the exciting success

of monoclonal antibodies directed against lymphocyte

surface antigens. Rituximab is a chimeric

(human-mouse) anti-CD20 antibody that induces

responses in approximately half of the patients with

relapsed indolent lymphomas and a third of patients

with relapsed aggressive lymphomas when used as a

single agent. Response rates appear even higher (up to

70%) for newly diagnosed patients treated with

Rituximab monotherapy.

Other promising antibodies for treatment of B cell

malignancies include epratuzumab (anti-CD22),

CAMPATH-1H (anti-CD52w), and Hu1D10 (anti-class II

HLA). Even more exciting than antibody monotherapy is

the prospect of combination antibody therapy (e.g.

rituximab + epratuzumab) or combination chemotherapy

and antibody therapy.

In this regard, a recent phase III randomized trial

from the GELA group in France demonstrated

statistically significantly superior complete and

overall response rates and superior event-free and

overall survivals for elderly patients with newly

diagnosed diffuse aggressive B cell lymphomas treated

with CHOP + rituximab compared with CHOP alone.

Confirmatory cooperative group trials combining

chemotherapy with antibody therapies are currently

underway.

Another approach to augment the efficacy of antibodies

is to deploy them in radiolabeled form. Iodine-131,

Yttrium-90, and Copper-67 labeled monoclonal

antibodies targeting CD-20, CD-22, HLA class II, and

other cell surface antigens have been tested and

demonstrate higher overall response rates (50-80%) and

complete response rates (20-40%) than unlabeled

antibodies. Pilot studies combining radiolabeled

antibodies with either standard dose chemotherapy or

myeloablative chemoradiotherapy with stem cell

transplantation also appear very promising.

Lymphoma vaccines have also produced very encouraging

results in single institution studies at Stanford and

the National Cancer Institute, with responding

patients demonstrating superior event-free and overall

survival than historical controls. Phase III

randomized trials of idiotype vaccines are currently

underway and novel new vaccine approaches are also

being tested.

Read the rest at:

http://www.asheducationbook.org/cgi/content/full/2001/1/221

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