Oncology Pharmaceuticals

This clinical update reports on the most recently published, relevant clinical findings demonstrating the potential of targeted oncology pharmaceuticals for increasing the survival rate of cancer patients, as compared with the standard oncological therapeutics relied upon to date. The results of the clinical investigations show therapeutic promise, but these findings must be corroborated with additional studies in other patient populations. Positive findings must be attained before the new combination of drugs can be recommended for standard therapy. In some cases, clinical studies revealed the efficacy and safety of a new pharmaceutical for the treatment of a cancer type refractory to previous treatments. In other instances, the use of known chemotherapeutic drugs at different doses or combinations might increase the survival rate in patients with advanced disease.

LYMPHOMA

The standard treatment for patients with diffuse large-ff-cell lymphoma is cyclophosphamide, doxorubicin, vincristine, and pred-nisone (CHOP). Rituximab, a chimeric monoclonal antibody against the CD20 ff-cell antigen, has therapeutic activity in diffuse largefkcell lymphoma. A randomized trial was conducted to compare CHOP chemotherapy plus rituximab with CHOP alone in elderly patients with diffuse large-ff-cell lymphoma. Previously untreated patients with diffuse large-f -cell lym-phoma, 60 to 80 years old, were randomly assigned to receive either eight cycles of CHOP every three weeks (197 patients) or eight cycles of CHOP plus rituximab given on day one of each cycle (202 patients).

The rate of complete response was significantly higher in the group that received CHOP plus rituximab than in the group that received CHOP alone (76%% vs. 63%%, P=0.005). With a median follow-up of two years, event-free and overall survival times were significantly higher in the CHOP plus rituximab group (P<0.001 and P=0.007, respectively). The addition of rituximab to standard CHOP chemotherapy significantly reduced the risk of treatment failure and death (risk ratios, 0.58 [95% confidence interval, 0.44 to 0.77] and 0.64 [0.45 to 0.89], respectively). Clinically relevant toxicity was not significantlygreater with CHOP plus rituximab. It was concluded that the addition of rituximab to the CHOP regimen increases the complete-response rate and prolongs event-free and overall survival in elderly patients with diffuse large-ff-cell lymphoma, without a clinically significant increase in toxicity. discount drugs canda

The combination regimen is the first to improve survival in this group of patients in more than 20 years. Data from a U.S. trial involving over 600 patients receiving rituximab and CHOP should be available later this year. Dr. Bruce D. Cheson of the National Cancer Institute in Bethesda, Maryland points out, “if these data confirm the findings of this trial, then we will certainly feel secure that an important breakthrough has been made.”