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LRF grant recipient publishes promising study offering hope to patients who fail to respond to chemotherapy or who relapse

Two-time LRF Mantle Cell Lymphoma (MCL) Initiative Award recipient, Ajay Gopal, M.D., Associate Professor, Department of Medicine, Division of Oncology, at the Seattle Cancer Care Alliance, has recently published a promising study in the British Journal of Hematology, which may solve the dilemma of how to effectively treat patients when chemotherapy regimens fail to make an impact in their initial treatment or following relapse.

The study is based on the first-of-its-kind phase I clinical trial to test the effectiveness of a new class of drugs that would enhance the effectiveness of standard chemotherapy treatments. Dr. Gopal, working with his colleagues at the Fred Hutchinson Clinical Research Division, found that giving patients high doses of a drug called Vorinostat, in combination with another round of commonly used second line drugs, results in a 70 percent response rate, including several patients whose lymphoma cells disappeared entirely. While patients involved in the trial had several types of lymphoma, the best responses were found in those with Hodgkin and diffuse large B-Cell lymphomas (DLBCL). Dr. Gopal explains that "the results of this study sets the stage for using a new class of drugs called histone-deacetylase inhibitors (HDAC), to sensitize tumor cells to the cancer-killing effects of chemotherapy."

As part of the study, researchers found that current 'front-line' chemotherapy drugs are still the most effective against fighting lymphoma. But for patients who relapse, long term disease free survival is less likely when 'salvage' therapies, used when standard therapies prove ineffective, are applied. The promising results from this first study with HDAC inhibitors may increase the likelihood of patients achieving longer term disease free status.

The next step in the progress of this study will be to conduct a phase II trial in patients with diffuse large B-cell (DLBC), as the drug's effectiveness was highest in this group of patients.

February 2013