All patients should know their options: Lymphoma drugs Bexxar and Zevalin

Linda Stephens had late-stage non-Hodgkins lymphoma, a cancer of the immune system that attacked her white blood cells, and a grim prognosis. Chemotherapy proved both difficult and ineffective. Less than a year after her diagnosis, the disease was spreading, and had involved every lymph node in her body. Now, at age 58, she has been cancer-free for seven years. Betsy de Parry (cancer-free for five years) and Dan Wheeler (cancer-free for three years) have similar stories. All had received Bexxar or Zevalin, which are costly, rarely used drugs in a new class, called radioimmunotherapies.

Clinical trials to show whether the drugs extend patients’ survival rates are nearing completion. Early studies showed the drugs have significant advantages over Rituxan, the mainstay drug for these patients. When it reviewed the clinical trials for Zevalin in 2001, the FDA found that "as compared with the Rituxan therapy, Zevalin was associated with a superior overall response rate."

Linda, Dan and Betsy are among the lucky few who receive Bexxar or Zevalin: only one tenth of the patients who would be suitable candidates for these drugs actually receive them.

Financial incentives discourage their use. Infusions of chemotherapy, Rituxan, and other drugs form the primary source of income for most oncologists. But Medicare and private insurers do not pay the oncologists for prescribing Bexxar and Zevalin, since these drugs must be administered in hospitals.

Also, most oncologists outside academic hospitals treat many different cancers, and may not be familiar with these drugs, which are used specifically for certain kinds of lymphoma.

Betsy de Parry says, "It’s not that I believe that radioimmunotherapy is right for everybody. I just think that all patients should know their options."

Non-Hodgkins lymphoma is the fifth most common cancer in the U.S., with 60,000 new patients diagnosed each year. About 20,000 people could be suitable candidates for Bexxar and Zevalin.

Advice for lymphoma patients: Learn more from the Lymphoma Research Foundation. And keep an eye out for news of the completion of the clinical trials.

Read one of our lymphoma survivor stories, or read more from today’s New York Times article by Alex Berenson.