Experimental therapy being used to treat non-Hodgkin's lymphoma

This year, 66,000 Americans will be diagnosed, and nearly 20,000 will die from non-Hodgkin's lymphoma.

These cancers of the white blood cells present symptoms such as enlarged lymph nodes, fever and weight loss, and don't always respond to traditional therapies.

Now, a national clinical trial is testing a new kind of chemo that could make a life-saving difference.

This has been the hardest year of Steven Guarin's young life.

"The first time they told me I was sick, the first thing I did was kind of jump on the guitar and try to forget," says Steven.

He's fighting a type of non-Hodgkin's lymphoma. Steven's endured chemo and a bone marrow transplant, but after the third relapse, he thought it was over.

"I stopped listening to music completely for four weeks," says Steven. "I even cut it off with friends. I was really depressed."

Dr. Joseph Rosenblatt of the UM Sylvester Comprehensive Care Center in Miami, Florida fought to get Steven into a clinical trial he thought could save his life.

"They didn't want to give an experimental medicine to someone who's sick, who's very sick," says Steven.

The experimental treatment links a powerful chemotherapy called mono-auristatin with an antibody developed at the University of Miami. The antibody -- SGN-35 -- targets the drug directly to a protein on the surface of lymphoma cells, leaving healthy cells alone.

"This is an emerging class of drugs in which you link an antibody that allows you to target vanishingly small amounts of chemotherapy because it all goes to where it's supposed to go," says Dr. Rosenblatt.

Within 36 hours, most of Steven's tumors disappeared. After four cycles of the new chemo, he was in complete remission -- with no side effects.

For the first time in a long time, Steven felt like he was winning his battle with cancer.

Steven was the very first U.S. patient in the phase II study for this still-experimental therapy.

Sadly, Steven passed away from a complication unrelated to this trial shortly after this interview. His family says he would have wanted to share his story to spread the word about the trial and help other cancer patients.


RESEARCH SUMMARY
TOPIC: NON-HODGKIN'S LYMPHOMA: RELAPSE TO REMISSION

BACKGROUND: Non-Hodgkin's lymphoma, which is also referred to as non-Hodgkin lymphoma, is a cancer that originates in the lymphatic system. This system is a disease-fighting network that's spread throughout the body. In non-Hodgkin's lymphoma, tumors develop from a type of white blood cell known as a lymphocyte.

There are many different subtypes of the disease. According to the National Cancer Institute, 66,000 Americans will be diagnosed with non-Hodgkin's lymphoma this year.

SIGNS AND SYMPTOMS: Symptoms may include swollen lymph nodes in the neck, armpit or groin; abdominal pain or swelling; chest pain or trouble breathing; fatigue; fever; night sweats; or weight loss. In most cases, people diagnosed with non-Hodgkin's lymphoma don't have any obvious risk factors. However, older age, being exposed to certain chemicals that are used to kill insects and weeds, taking medications that suppress the immune system, and having certain viral and bacterial infections appear to increase a person's risk of developing the cancer.

STANDARD TREATMENT: If a patient's lymphoma appears to be slow-growing, doctors may use a "wait-and-see" approach, which means treatment may not be necessary. Many of these cancers that don't cause symptoms may not require treatment for years. If a patient's cancer is more aggressive, treatments such as chemotherapy, radiation, stem cell transplants, immune-boosting medications and radioimmunotherapy drugs may be used.

A NEW OPTION: Now, researchers are testing a new type of chemotherapy that could help patients with non-Hodgkin's lymphoma. The experimental treatment links a powerful chemotherapy called mono-auristatin with an antibody called SGN-35. The antibody directs the drug directly to a protein on the surface of lymphoma cells and leaves healthy cells alone.

ONE PATIENT'S STORY: Steven Guarin was the very first patient in the U.S. who took part in the phase II clinical trial testing the SGN-35 therapy. Within 36 hours of receiving the treatment, Steven's tumors disappeared. After four cycles, he was in complete remission. However, Steven passed away after opting for another experimental procedure. In an effort to prolong his remission, he had a cord blood transplant.

Unfortunately, the toxicity of the transplant caused his death. Steven's family says he would have wanted to share his story.

FOR MORE INFORMATION, PLEASE CONTACT:
Joseph Rosenblatt, M.D.
UM Sylvester Comprehensive Cancer Center
Miami, FL
jrosenblatt@med.miami.edu


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