Tag Archive for: POLARIX

What Are Common Side Effects of DLBCL Treatment?

What Are Common Side Effects of DLBCL Treatment? from Patient Empowerment Network on Vimeo.

Lymphoma expert Dr. Matthew Matasar reviews common side effects of diffuse large B-cell lymphoma (DLBCL) treatment.

Dr. Matthew Matasar is a lymphoma expert at Memorial Sloan Kettering Cancer Center and Chief of Medical Oncology at Memorial Sloan Kettering Bergen. To learn more about Dr. Matasar, visit here.

See More From The Pro-Active DLBCL Patient Toolkit

Related Programs:

How Can You Access DLBCL Clinical Trials?

Emerging DLBCL Treatment Approaches

Emerging DLBCL Treatment Approaches

What Helps Determine a CLL Patient’s Treatment Options


Transcript:

Katherine Banwell:

What are common side effects of DLBCL treatment approaches? 

Dr. Matasar:

Like anything, the side effects are dependent upon the treatments that we use. So, treatments that use chemotherapy-based approaches will often have the side effects that we associate with chemotherapy. And obviously not all chemotherapies are created equally. But treatments like R-CHOP or R-CHP-pola, or Polarix regimen, these are treatments that use traditional cytotoxic chemotherapy agents and anthracycline based chemotherapy that have well-characterized side effects that are unfortunately unavoidable but often temporary things like hair loss.  

And hair loss is unavoidable with these treatments although temporary.   

The Oncovin or polatuzumab treatments can lead to a problem called neuropathy, which can manifest as numbness or tingling in the fingers or toes or constipation because our intestines have nerves too that are affected by these treatments. Certainly fatigue and lowering of the immune system are common with these and other chemotherapy medicines as well. And your doctors will always talk to you about ways to reduce the risk of infection such as vaccination and such as anti-infective medicines or immune boosting medicines to try to limit the risk of infection while receiving such treatments.  

Why Should You Consider Seeing a DLBCL Specialist?

Why Should You Consider Seeing a DLBCL Specialist? from Patient Empowerment Network on Vimeo.

Lymphoma expert Dr. Matthew Matasar explains the benefits of seeing a diffuse large B-cell lymphoma (DLBCL) specialist and encourages patients to be partners in their own care.

Dr. Matthew Matasar is a lymphoma expert at Memorial Sloan Kettering Cancer Center and Chief of Medical Oncology at Memorial Sloan Kettering Bergen. To learn more about Dr. Matasar, visit here.

See More From The Pro-Active DLBCL Patient Toolkit

Related Programs:

What Do DLBCL Patients Need to Know About Treatment and Research?

Tips for Making Treatment Decisions WITH Your DLBCL Team

Advice for Speaking Up About Your DLBCL Care

Advice for Speaking Up About Your DLBCL Care


Transcript:

Katherine Banwell:

Why should DLBCL patients consider seeing a specialist? What are the benefits? 

Dr. Matasar:

The benefits of a specialist in the treatment of diffuse large B-cell lymphoma is that this field is changing rapidly. Treatments like this R-CHP-pola regimen, we understand that these data are very new reported only months ago but perhaps academic centers may have a greater sophistication or comfort with using these newer data to support the care of our patients.  

The second is that there are many important and highly relevant clinical trials that are ongoing as we continue to try to improve outcomes for patients with diffuse large B-cell lymphoma either receiving their first treatment or for those patients who, unfortunately, suffer relapse. Some of these treatments may only be available at academic centers of excellence and understanding that your options for treatment may be different under the care of an expert in this disease is an important thing to consider when trying weigh how best to approach receiving care.  

What Do DLBCL Patients Need to Know About Treatment and Research?

What Do DLBCL Patients Need to Know About Treatment and Research? from Patient Empowerment Network on Vimeo.

How have diffuse large B-cell lymphoma (DLBCL) treatment options evolved? Lymphoma expert Dr. Matthew Matasar reviews current treatment options for DLBCL and shares his perspective on where research is heading.

Dr. Matthew Matasar is a lymphoma expert at Rutgers Cancer Institute. To learn more about Dr. Matasar, visit here.

See More From The Pro-Active DLBCL Patient Toolkit

Related Programs:

What Are Common Side Effects of DLBCL Treatment?

What Are Common Side Effects of DLBCL Treatment?

Why Should You Consider Seeing a DLBCL Specialist?

An Expert Overview of DLBCL Treatment Approaches


Transcript:

Katherine Banwell:

Dr. Matasar, what are the types of treatments currently available to treat DLBCL? 

Dr. Matasar:

So, DLBCL, or diffuse large B-cell lymphoma, is the most common type of aggressive B-cell non-Hodgkin’s lymphoma in America and really around the world. Aggressive lymphomas are a double-edged sword. They tend to grow quickly over weeks to months, and they tend to make people feel sick if left untreated, but they’re potentially curable in many although not all patients.  

We now have a growing body of treatment options available to maximize the changes of cure and to minimize short and long-term risks in patients diagnosed with aggressive B-cell lymphomas.  

The first recent innovation is a treatment program that seems to improve upon the standard of care treatment called R-CHOP, R-C-H-O-P, which is a combination of chemotherapy and immunotherapies in the treatment of newly diagnosed diffuse large B-cell lymphoma. And this new regimen substitutes out one of those medicines, the O, which is a medicine called Oncovin, or vincristine, with a newer medicine that has a long name called polatuzumab vedotin, or pola for short. And we found in the recent Polarix trial was that by introducing this new pola medicine instead of the older Oncovin treatment, we’re able to lead to longer durations of remission for patients with newly diagnosed large cell lymphoma and is able to do so without any increase in short- or long-term side effects, which makes it a real win in my mind.  

That’s one major innovation. The second is in patients who, unfortunately, have a relapse of their diffuse large B-cell lymphoma or whose disease does not go into remission after first treatments. We now know that patients who have an early relapse or have, what we call, primary refractory disease, meaning it didn’t go away after the first treatment at all, is we now have data using treatments that are calling CAR-T cell, or chimeric antigen receptor modified T-cell therapy. CAR-T cell therapy is a treatment in which we use your own body’s healthy T cells. Some of those are filtered out, and they are genetically re-engineered in way that trains them to attack lymphoma cells and then given back as a living treatment, as a mini-transfusion.  

This CAR T-cell therapy was compared to a standard chemotherapy program that uses high dose therapy with stem-cell rescue or auto transplant, or stem cell transplants, for patients with this high-risk scenario, early relapse or primary refractory disease. 

And what we found is that CAR T-cell therapy with either the treatment called axi-cel (Yescarta) or the treatment called liso-cel (Breyanzi),two different CAR-T therapies, were superior to the traditional chemotherapy and stem-cell transplant approach in these highest risk patients leading to marked improvements in outcomes in these patients and maybe even improving overall survival, which is a very high benchmark at this early time point in these two critical trials. So, improvements in newly diagnosed therapy and improvements for those patients who suffer early relapse or primary refractory disease mark two important advances in the care of patients with DLBCL.  

Katherine Banwell:

What are you excited about when it comes to DLBCL treatment and research?  

Dr. Matasar:

What I’m most excited about is our ability to improve outcomes in the highest risk patients. We often talk in academic circles about unmet need, which is just a silly way of saying we really wish we could do better. And there’s unmet need across the line when we think about how we take care of patients with aggressive B-cell lymphoma, newly diagnosed patients, patients who are newly diagnosed who may be older or more frail, who may need specialized treatment approaches, patients who suffer a relapse of this disease one or multiple times.  

We cure many patients with diffuse large B-cell lymphoma, but many is not enough. And we’re not going to rest until we can have uniform and universal success and, unfortunately, we’re not there. But we’re working to get there day after day. The options are expanding. The trials are promising. Novel therapies are very exciting, and I really believe that these next years are going to see profound innovation and improvements in outcomes. That comes with clinical research and with patients being willing to trust doctors to participate in this journey together and doctors being willing to take a chance and offer patients novel therapies when we know that our current treatments are simply inadequate. 

How Is DLBCL Treated?

How Is Diffuse Large B-Cell Lymphoma (DLBCL) Treated? from Patient Empowerment Network on Vimeo.

Dr. Justin Kline explains what patients need to know about current DLBCL treatment, including R-CHOP, stem cell therapy, and clinical trials.

Dr. Justin Kline is the Director of the Lymphoma Program at the University of Chicago Medicine. Learn more about Dr. Kline, here.

See More From The Pro-Active DLBCL Patient Toolkit

Related Programs:

Which Factors Impact DLBCL Treatment Decisions?

Which Factors Impact DLBCL Treatment Decisions?

How Is DLBCL Treatment Effectiveness Monitored?

How Is Relapsed/Refractory DLBCL Treated?

How Is Relapsed/Refractory DLBCL Treated?


Transcript:

Katherine:      

From what I understand, treatment really should start right away. So, what types of treatment are currently available to someone newly diagnosed with DLBCL?

Dr. Kline:       

Sure, so for about 20 plus years now, the standard of care for most patients with DLBCL, regardless of whether it’s a germinal center or an activated B-cell type DLBCL, is a combination of what we call chemo immunotherapy, the acronym for which is R-CHOP, and each of those letters stands for a different medication. The R stands for rituximab, which is an antibody that coats the surface of lymphomatous B cells and sort of signals the immune system to come and kill those cells.

The C is cyclophosphamide, the H is hydroxy doxorubicin, and the O is Oncovin. These are each classical chemotherapy drugs, and they each work through a different mechanism to help kill lymphoma sells. And the P is a steroid pill called prednisone, so it’s a little bit complicated, but the reason that we use cocktails of medicines to treat lymphomas is that it really works to prevent the lymphoma cells from gaining the upper hand, from developing resistance to a single type of treatment.

Katherine:      

Right.

Dr. Kline:       

Now, I should say that for certain DLBCLs, particularly those double hit lymphomas that we talked about, sometimes we use a more intensive cocktail called dose-adjusted R-EPOCH. It has largely the same medications with an additional chemotherapy called etoposide.

The difference is that R-CHOP is given – all the drugs are given intravenously, with the exception of prednisone, over a single day. The dose-adjusted R-EPOCH is given over an infusion over the course of about five days. The other point I might make is that there was a recent large clinical study that compared R-CHOP to a new regimen called polatuzumab R-CHP. So, basically the O in R-CHOP was removed and substituted for this new drug called polatuzumab vedotin, and although many, many combinations similar to R-CHOP have been compared to R-CHOP over the past 20 years and failed, this regimen, polatuzumab R-CHP in the study called the POLARIX study actually was shown to improve what we call progression-free survival by about six percent. So, it may become a new standard of care for treating DLBCL, which is exciting, because we haven’t had one in over 20 years.

Katherine:                  

Right. That’s good news.

Dr. Kline:       

Long answer to a short question, sorry about that. Yes, it is good news.

Katherine:      

That is good news. What about stem cell transplants?

Dr. Kline:       

Good question. So, for newly diagnosed patients, in this era, we rarely if ever are recommending stem cell transplant or stem cell transplantation as part of initial therapy. There are rare circumstances, but for the vast majority of patients who are, people who are diagnosed with DLBCL, it’s not recommended.

Katherine:      

Where do clinical trials fit in?

Dr. Kline:       

It’s a really good question. I practice at an academic medical center, and so one of our missions is to advance therapy and make it better. There’s no way to do that without performing clinical trials, so I think for – clinical trials aren’t for everyone. As a matter of fact, most people with lymphoma are not treated in the context of clinical trials.

But certainly I think they are important to consider, and number one, it’s possible that the particular person might be involved with the clinical trial that is very successful and actually improves their outcome. I always tell people that I see that being involved with the clinical trial is also, to some extent, an altruistic endeavor. You’re helping your doctors learn more about how to treat a type of cancer, hopefully better, maybe not, you know? So, there is some altruism that goes into clinical trials as well. So, I do think that most people who are able should consider having a second opinion. Doesn’t have to be at an academic medical center, but at least with another doctor, where clinical trial options can be discussed.