Along with Zevalin, Bexxar is one of two radioimmunotherapy agents effective against follicular lymphoma. In both cases, these drugs combine an anti-CD20 monoclonal antibody, similar to rituximab, with a radioactive isotope, in this case iodine-131.
Availability in Canada: Bexxar has been approved by Health Canada, but provincial funding is limited. Only the BC Cancer Agency has approved funding for Bexxar, and its protocol stipulates that the drug be used in a third-line setting. Bexxar has achieved success in trials in both treated and untreated patients; its use is reserved largely for cost reasons and because of existing effective first-line treatments.
How Bexxar Works:
Side Effects: Bexxar has very serious side effects.
Bexxar Monotherapy: One Bexxar monotherapy trial reported a 95% response rate (with 75% achieving complete remission) and median progression-free survival of 6 years.
Bexxar Combination Therapy: Clinical trial results have varied substantially, probably as a result of differing eligibility conditions. One trial combined Bexxar with CHOP, and found lower figures: a 90% response rate (with 67% entering complete remission), with 81% progression-free after 2 years. The most impressive figures come from a Bexxar-CVP trial, which had a 93% complete remission rate and a median progression-free survival of at least 8 years.
Published Studies
Mark S. Kaminski et al. "131I-Tositumomab Therapy as Initial Treatment for Follicular Lymphoma." New England Journal of Medicine (2005).
Brian K. Link et al. "Cyclophosphamide, Vincristine, and Prednisone Followed by Tositumomab." Journal of Clinical Oncology (2010).
Oliver W. Press et al. "A Phase 2 Trial of CHOP Chemotherapy Followed by Tositumomab." Blood (2003).
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