New drug approved for treatment of lymphoma subtype

Image credit – National Cancer Institute

CANCER DIGEST – May 14, 2022 – The FDA has granted provisional approval for a new drug to treat a form of slow-growing cancer called marginal zone lymphoma. The approval is based on early results of a small clinical trial and a secondary study.

The drug, zanubrutinib, belongs to a new class of drug that blocks a certain enzyme that plays a crucial role in allowing the cancer to survive and grow. The results of the early clinical trial led by Tycel Phillips, MD, of the University of Michigan appear in the April 7, 2022 journal Blood Advances.

Marginal zone lymphoma (MZL) is a group of slow growing non-Hodgkin B-cell lymphomas, which account for approximately eight percent of all NHL cases. The average age at diagnosis is 60 years, and it is slightly more common in women than in men, and has few treatment options.

These lymphomas are called marginal zone according to the area of the immune system the cancer started. The largest group of these cancers start outside the lymph nodes and are centered in the stomach, small intestine, salivary glands, thyroid, eyes and lungs, according to the Lymphoma Research Foundation.

In the early clinical trial, 16 of 20 patients with MZL had their cancers shrink and 5 of the 20 had a complete response, meaning the cancer disappeared. Progression-free survival, meaning the period of time cancer had not grown had not been reached after a median of 33.8 months.

In 33 patients with a similar type of cancer, called follicular lymphoma, imaging after treatment showed no sign of cancer in 18 percent of them.

“Treatment options with improved tolerability and better disease control were much needed for marginal zone lymphoma and follicular lymphoma,” said Phillips, M.D. in a press release. He is a hematologist at the Rogel Cancer Center. “While the small size of this study limits broad conclusions, the safety and efficacy results highlight the potential for zanubrutinib as an addition to available therapies for these cancers.”

Given the limited treatment options for marginal zone lymphoma that has returned or proven resistant to other treatments, and based on the results of this research and a secondary study named MAGNOLIA, the Food and Drug Administration approved zanubrutinib on a contingent basis. Full approval will be based on larger clinical trials.

Dr. Phillips receives consulting fees from BeiGene, Ltd., the manufacturer of the drug studied in this clinical trial.

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Sources: Michigan Health Lab news, Blood Advances, and Lymphoma Research Foundation