Hope 4 Patients With Aggressive Lymph Node Cancer
Wednesday 12 December, 2001
Study brings hope for New Zealand Patients With Aggressive Lymph Node Cancer
New Zealand oncologists and haematologists have welcomed the results of a European study, which reveals the most significant advance in treating the aggressive form of blood cancer, non-Hodgkin's lymphoma (NHL), in 20 years.
The findings of the pivotal two year GELA study show that a new drug combination of MabThera (rituximab-currently used for treating low grade NHL) plus CHOP (standard chemotherapy) increases the patients chance of being clear of their cancer by the end of treatment, from 63 % to 76 %. This is compared to CHOP (standard chemotherapy) alone. Current medical opinion indicates that if patients treated with standard chemotherapy survive past the two-year milestone their chances of a cure can be up to 90%.
The findings were presented for the first time at the American Society of Haematology (ASH) conference in Florida today.
A leading Auckland oncologist, Dr Vernon Harvey, expects that up to 40 more New Zealanders suffering from aggressive NHL could be saved every year if these results can be confirmed by further studies.
"These findings are very promising. A possible increase in overall survival of 10% is extremely significant. This particular study was confined to elderly patients, but if the treatment is shown to be equally effective in younger patients as well, then with approximately 400 cases of NHL a year diagnosed in New Zealand, then there are potentially another 30 to 40 people a year alive thanks to this advance."
Dunedin oncologist, Dr David Perez agrees. "It's one of the most significant medical breakthroughs that I can recall in the past 10 years at least. Anything that offers a cure rather than prolonged time has potential to be considered a medical breakthrough, and these results are strongly pointing to that.
Dr Perez also says that the 26 month period over which the GELA study was conducted is still a relatively short time in the medical world.
"Once the combination of MabThera plus CHOP has had time to prove it can increase the cure rate, then we can deem it a success. However the GELA study evidence is very conclusive. The combination clearly prolongs the lives of aggressive NHL sufferers, however it will take some time to determine the cure issue."
"With our ageing population, people over 60 are particularly susceptible to aggressive NHL, however their bodies aren't so receptive to chemotherapy. MabThera plus CHOP is a kinder form of treatment with fewer side effects. It gives people better control of their lymphomas and a higher possibility of a cure."
In New Zealand, the incidence of NHL rose 300% between 1987 and 1997. It continues to climb, and Dr Perez says while our ageing population is partly a factor in this increase, there are other contributing factors that are poorly understood.
MabThera is currently registered and funded for low grade NHL in New Zealand. An application to register the use of MabThera for Intermediate/ High-Grade non-Hodgkin's lymphoma has been submitted to the New Zealand Ministry of Health. Both Doctors Harvey and Perez say they will be telling patients of the GELA study findings. "I will be informing my patients of the option, but funding will need to be approved by the Ministry of Health before we can prescribe it as of right," said Dr Perez.
"We need to establish its availability first, so we need to be careful when telling patients as it's a dilemma if it's not available. The key problem is going to be the cost of the treatment. We're talking around $17, 000 per patient for four cycles, which is not accessible for most people," said Dr Harvey.
Worldwide, 1.5 million people have NHL, 55% have the aggressive form of the disease. Internationally, NHL is the third fastest growing form of cancer after skin and lung cancer. In New Zealand, it is the sixth most common form of cancer and is more common than leukaemia.
For further information, please contact: Dr David Perez Dunedin Hospital Ph: (03) 474 0999 (main number - please ask for Dr Perez to be paged)
Dr David Perez is a Senior Lecturer in Medical Oncology at Dunedin School of Medicine and Oncology Consultant to Otago District Health Board. His practice involves the medical treatment of all types of cancer, including lymphomas. He is currently National President of the Cancer Society.
Dr Vernon Harvey Auckland Hospital Ph: (09) 307 4949 -ext: 6267 (Please go through Oncology Department secretary) Mob: 025 958 726 after hours
Dr Vernon Harvey, MD, FRCP, FRACP, FAChPM, Medical Oncology. Dr Harvey is the Associate Professor of Oncology, and the Clinical Director of Medical Oncology at Auckland Hospital.
Rob Mitchell General Manager Roche Products (NZ) Ltd
To contact Mr Mitchell, please phone Clare England on 021 615 915, or (09) 306 5808