Last update: 04/15/2008

TOPIC SEARCH: ASCO | ASH | ClinicalTrials.gov | Medscape | PubMed 

 under construction

There's an urgent need for effective therapies that have lower and/or more transient toxicity, because the cumulative affect of treatment toxicity - particularly myelosuppression - can limit the range of treatments available to patients with lymphomas and other cancers.  

Myelosuppression is a state of impaired bone marrow function that results in low blood cell counts, inadequate immunity leading to increased risk of infection, and lower tolerance for   additional cancer treatment.

Here we will list approved and investigational agents that are thought to be less toxic, or that are less myelosuppressive than standard chemotherapies.  Be aware that toxicity to other organs, such as to the liver and kidneys, can pose dangers as well

We are *not* advocating for the avoidance of toxic therapies. Indeed, toxicity alone can be a poor criterion for selecting a therapy if it leads to under-treating an aggressive or high-risk lymphoma, for example, that might be cured with a more aggressive approach.

Therapies with low toxicity

Investigational: BL22 immunotoxin can find tumor cells that express cd22 and kill them without harming normal cells.

Phase 1 Study of BL22 to Treat Acute Lymphocytic Leukemia or Non-Hodgkin's Lymphoma in  Children and Young Adults  (study suspended) OR

BL22 Immunotoxin in Treating Patients With Refractory Chronic Lymphocytic Leukemia, Prolymphocytic Leukemia, or Non-Hodgkin's Lymphoma 


Condition: CD22-positive lymphomas and leukemias

TOPIC SEARCH: PubMed

Gallium Nitrate

Investigational: Gallium Nitrate (Ganite®) previously received FDA approval as treatment for cancer-related hypercalcemia. "Gallium nitrate causes little myelosuppression and is therefore well tolerated by patients with advanced disease who have received extensive prior therapy. Given its unique mechanism of action, the high level of single-agent activity in published clinical trials, the absence of significant myelosuppression, and the potential lack of cross-resistance, further clinical study of gallium nitrate both alone and in combination with other active agents is warranted." ~ Gallium nitrate in the treatment of lymphoma. Semin Oncol. 2003 Apr;30(2 Suppl 5):25-33. Review. PMID: 12776257

TOPIC SEARCH: ClinicalTrials.gov

Idiotype Vaccine 

Investigational: Idiotype vaccine may induce adaptive immunity against lymphoma tumors.

Probable Settings: since this is an immune therapy, the ideal setting is probably in patients who are not immune compromised - such as to consolidate response to early treatment, or early use as an alternative to watchful waiting.  

See Vaccines

Radiofrequency Ablation (not typically available in clinical practice) 

See RFA

 

Rituxan 

Approved for cd20-positive b-cell lymphomas: Rituxan - binds to cd20 tumor cells.  It can induce cell death directly and/or by "flagging" lymphoma cells for attack by immune cells. 

Salvage therapy for relapsed aggressive NHL?

"Although a higher response is seen in indolent NHLs, the response rate of patients with relapsed aggressive NHL to single agent rituximab is 31% (22% partial remission, 9% complete remission)"  ncbi.nlm.nih.gov 

See Rituxan

Spirogermanium

Investigational: Phase I study of spirogermanium given daily  jco.org 

"Spirogermanium, an azaspirane compound, has recently had limited clinical trials using a schedule of intravenous injection one to three times every week. The observation of clinical antitumor activity and lack of myelosuppression prompted us to investigate further the clinical effects of spirogermanium administered on 
various schedules. ... Of the 44 assessable patients, 3 demonstrated a partial response and 3 had minor tumor regression; all responses occurred in lymphoma patients."

Clinical Trial - Cancer.gov

OTHER

The following agents are reported to have favorable toxicity profiles.  Click the agent to start a search.