Genentech drug delays follicular lymphoma progression, vegetables prevent it

A new phase II trial showed using Rituxan or rituximab made by Genentech, Inc, a biotechnology company of the Roche Group, and Biogen Idec, benefited patients with asymptomatic advanced follicular lymphoma.

Follicular lymphoma as a common type of non-Hodgkin’s lymphoma accounts for 15 to 20 percent of 65,540 non-Hodgkin’s lymphoma cases diagnosed in 2010.  Each year about 20,000 people die from the cancer.

Early studies suggested immediate chemotherapy after diagnosis does not help asymptomatic patients who are often advised to simply watch and wait to use treatment until the disease progresses to a certain degree to justify the treatment.

The trial data presented by Kirit Ardeshna M.D. at the 52nd Annual Meeting of the American Society of Hematology in Orlando, Florida showed treatment with Rituxan extended survival of follicular lyphoma patients.

The trial compared patients who followed the watch-and-wait approach with those who were given Rituxan in an initial phase and then a maintenance phase. The trial results showed Rituxan delayed the need for chemotherapy.

Among those who followed the traditional watch-and-wait approach, the average time to initiation of new therapy such as chemotherapy or radiotherapy was 34 months whereas the average profession-free survival was 23 months.

In contrast, among those who received Rituxan, the time for the need of additional therapy was reduced by 80 percent and the risk of disease progression was decreased by 79 percent.  The progression free survival was extended to up to 4 years.

Rituxan carries some severe side effects including infection, which affected 4 percent of patients, allergy affecting 3 percent, neutropenia affecting 3 percent and neutropenic sepsis 1 percent.

How to avoid follicular lymphoma?

Studies suggest risk of follicular lymphoma is associated with a person's diet to say the least.  A new study linked nitrite intake with increased risk of follicular lymphoma.

The study published in the June 2010 issue of Cancer Causes & Control showed those whose intake was in the highest quartile were 40 percent more likely to be diagnosed with follicular lymphoma, compared with those whose intake was in the lowest quartile.

Klifoy B.A. and colleagues of National Institutes of Health found the association after  they studied data from 1,304 women in Connecticut.

Another study led by Erber E. and colleagues from University of Hawaii and published in the Aug 2009 issue of Leukemia & Lymphoma suggests high vegetable dietary pattern may reduce the risk of follicular lymphoma by up to 44 percent whereas the fat and meat dietary pattern boosted the risk by 5 times.

The study was based on data from the Multiethnic Cohort including more than 215,000 Caucasians, African-Americans, Japanese-Americans, Native Hawaiians, and Latinos aged 45-75 at baseline.

Another study came to a similar conclusion that higher intake of total fruits and vegetables may cut the risk of follicular lymphoma by 31 percent.  Among fruits and vegetables, yellow/orange, cruciferous vegetables, broccoli, and apple juice/cider were associated with lower risk of non-Hodgkin's lymphoma.

The study was conducted by Thompson C.A. and colleagues from College of Medicine Mayo Clinic in Rochester, MN and published in the Feb 15, 20010 issue of International Journal of Cancer.

David Liu