Two-drug combo could help treat cancer

Washington –  One drug attacks tumor cells directly, the other treats the immune system by taking the brakes off T cell response, and together, they put half of the patients with relapsed follicular lymphoma into complete remission.

Senior author Sattva Neelapu, M.D., Ph.D., associate professor of Lymphoma/Myeloma at MD Anderson, said that most drugs target only the tumor, this combination is complementary, treating both the lymphoma cells directly and the T cells in a manner that activates them against cancer cells.

He said that the combination of the established antibody drug rituximab with the experimental drug pidilizumab so far also has a remarkably mild side effect profile.

Of 29 study participants at a median follow-up of 15.4 months, 19 (66 percent) had either a complete or partial response, with 15 (52 percent) having a complete response.

There were no grade 3 or 4 adverse events, with all effects at the less serious grade 1 and 2 levels. Patients had no indicators of autoimmunity, which can be an issue in the class of drugs that blocks immune system checkpoints and activate T cells. Such mild effects are particularly important for follicular lymphoma patients, who are diagnosed with the disease at a median age of 60.

Neelapu said that Rituximab treatment alone usually achieves a 40 percent overall response rate and about 11 percent complete responses, asserting that the side effect profile of the combination is about the same as rituximab alone.

He added pidilizumab greatly improves responses so far at little cost in additional side effects.
The study has been published in the journal The Lancet Oncology.