Targeted therapy for non-Hodgkin lymphoma
Targeted therapy is usually used to treat B-cell non-Hodgkin lymphoma (NHL). It uses drugs to target specific molecules (such as proteins) on or inside cancer cells. These molecules help send signals that tell cells to grow or divide. By targeting these molecules, the drugs stop the growth and spread of cancer cells while limiting harm to normal cells. Targeted therapy may also be called molecular targeted therapy.
You may have targeted therapy to:
- kill or slow the growth of lymphoma cells
- deliver radioactive substances (called radioactive isotopes) directly to a tumour
Your healthcare team will consider your personal needs to plan the drugs, doses and schedules of targeted therapy. You may also receive other treatments.
Targeted therapy drugs used for NHL @(Model.HeadingTag)>
The following targeted therapy drugs may be used to treat certain types of NHL.
Rituximab (Rituxan) is the most common targeted therapy drug used to treat NHL. It is often combined with chemotherapy, but it can also be used by itself. Rituximab is given by a needle in a vein (intravenously).
Brentuximab vedotin (Adcetris) may be used along with chemotherapy to treat some types of NHL that express CD30.
Alemtuzumab (Campath) may be given to some people with NHL that no longer responds to other treatments. It is given either intravenously or by an injection just under the skin (called subcutaneous injection).
Ofatumumab (Arzerra) is most often used to treat some types of NHL when they no longer respond to other treatments. It is given intravenously.
Bortezomib (Velcade) may be used to treat some types of NHL. It is most often given after doctors have tried other treatments. It is given intravenously or by a subcutaneous injection.
Obinutuzumab (Gazyva) is most often used to treat some types of NHL when they no longer respond to other treatments. It is given intravenously.
Idelalisib (Zydelig) may be used to treat some types of NHL after doctors have tried other treatments. It is taken as a tablet by mouth.
Ibrutinib (Imbruvica) may be used to treat some types of NHL after doctors have tried other treatments. It is taken as a capsule by mouth.
Acalabrutinib (Calquence) may be used to treat mantle cell lymphoma that has been treated by at least one other therapy.
Ibritumomab (Zevalin) is a type of radioimmunotherapy. The drug attaches to the cancer cells and delivers a radioactive material directly to them, which may mean fewer or less severe side effects. It is given intravenously.
Ibritumomab contains a radioactive substance, so you may need to take special precautions to protect others from being exposed to radiation for 1–2 weeks after treatment. Talk to your healthcare team about any special precautions that you need to take.
Side effects @(Model.HeadingTag)>
Side effects can happen with any type of treatment for NHL, but everyone’s experience is different. Some people have many side effects. Other people have few or none at all.
Targeted therapy doesn’t usually damage healthy cells, so it tends to cause fewer and less severe side effects than chemotherapy and radiation therapy. Chemotherapy and radiation therapy can damage healthy cells along with cancer cells.
If side effects develop with targeted therapy, they can happen any time during, immediately after or a few days or weeks after targeted therapy. Sometimes late side effects develop months or years after targeted therapy. Most side effects go away on their own or can be treated, but some side effects may last a long time or become permanent.
Side effects of targeted therapy will depend mainly on the type of drug or combination of drugs, the dose, how it’s given (by mouth or by a needle in a vein) and your overall health. Some common side effects of targeted therapy drugs used for NHL are:
- nausea and vomiting
- loss of appetite
- low blood cell counts
- fever and chills
- skin rash
- infection in one or both lungs (called pneumonia)
- blood clots
Tell your healthcare team if you have these side effects or others you think might be from targeted therapy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.
Information about specific cancer drugs @(Model.HeadingTag)>
American Cancer Society. Non-Hodgkin Lymphoma. 2014: http://www.cancer.org/acs/groups/cid/documents/webcontent/003126-pdf.pdf.
BC Cancer Agency (BCCA). Skin Lymphoma. 2014: http://www.bccancer.bc.ca/.
Cancer Care Ontario. Drug Formulary. Toronto, ON: Cancer Care Ontario;
Faber EA, Vose JM, Armitage JO, Bierman PJ . Diagnosis and treatment of non-Hodgkin's lymphoma of adults. Wiernik PH, Goldman JM, Dutcher JP, Kyle RA (eds.). Neoplastic Diseases of the Blood. 5th ed. Springer; 2013: 47: 1027-1047.
Freedman AS, Jacobson CA, Mauch P, Aster JC . Non-Hodgkin lymphoma. DeVita VT Jr, Lawrence TS, & Rosenberg SA. Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2015: 103:1552-1583.
Health Canada. Drugs and Health Products: Zydelig. Ottawa, ON: Health Canada; 2015: http://www.hc-sc.gc.ca/dhp-mps/prodpharma/notices-avis/conditions/zydelig_dhcpl_lapds_172652-eng.php.
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