Treatment strategies and outcomes for patients with
non-Hodgkin's lymphoma (NHL) are undergoing rapid and important evolution. We have recently witnessed the advent of novel targeted
therapies, such as gene
therapies, active immunotherapies, antisense
therapies, new small molecules and biologicals, and
monoclonal antibodies (MoAbs). The first MoAb approved for the treatment of
cancer,
rituximab, was approved in 1997 and has been rapidly incorporated into treatment regimens for NHL. In a randomized trial in combination with CHOP
chemotherapy (
cyclophosphamide, hydroxydaunomycin,
vincristine, and
prednisone),
rituximab showed superiority to CHOP for patients with diffuse large cell NHL (DLCL).The
rituximab + CHOP combination has become the gold standard for frontline
therapy for DLCL and has shown significant activity in the management of follicular NHL. In February 2002, the first radioimmunotherapeutic agent for the treatment of
cancer,
ibritumomab tiuxetan (
Zevalin), was approved.
Ibritumomab tiuxetan, an
yttrium-labeled antibody used in conjunction with
rituximab, has significant activity in follicular and transformed NHL. Use of
rituximab has proved that
antibodies are safe and active even as single agents. The results have helped dispel the negativity and biases resulting from many years of disappointing results in this important area of research. Results with
rituximab have opened the doors to continued research and have provided the impetus necessary for renewed enthusiasm and optimism in continuing the search for curative regimens for patients with NHL.