Nevada Cancer Institute Physician-Scientist Creates Less Toxic Cancer Therapy For Chronic Lymphocytic Leukemia

Main Category: Lymphoma / Leukemia / Myeloma
Also Included In: Blood / Hematology;  Cancer / Oncology
Article Date: 06 Feb 2009 - 2:00 PDT

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Nevada Cancer Institute researcher and oncologist Kenneth A. Foon, M.D., had a paper published in the Feb. 1, 2009 issue of the Journal of Clinical Oncology regarding a new, highly effective novel therapy for chronic lymphocytic leukemia.

Dr. Foon, head of the leukemia section at NVCI, was successfully recruited to the Institute from University of Pittsburgh Cancer Center this past summer. As a clinical investigator, Dr. Foon brings the latest therapies from the lab to the patient.

This paper, titled "Chemoimmunotherapy With Low-Dose Fludarabine and Cyclophosphamide and High Dose Rituximab in Previously Untreated Patients With Chronic Lymphocytic Leukemia," was recently published in the periodical, Journal of Clinical Oncology (Vol 27, No 4 February 1, 2009), and was also published in the online version of the journal.

The paper reports on a trial designed by Dr. Foon whose purpose was to maintain the high responses but reduce the toxicity of the popular treatment FCR (a combination of two toxic chemotherapy agents, fludarabine and cyclophosphamide, with the less toxic monoclonal antibody rituximab), by decreasing the fludarabine and cyclophosphamide, which Dr. Foon dubbed "FCR-Lite."

"The study was designed to develop a low toxicity highly effective therapy for this very common disease of an elderly population," Dr. Foon said.

The article reports that major toxicity to the bone marrow that was seen in 51 percent of cycles of FCR was reduced to only 13 percent of cycles with FCR-Lite, and there was no long-term damage to the bone marrow with FCR-Lite.

The article also reports that 77 percent of patients treated on this trial had complete disappearance of their leukemia. While Dr. Foon does not believe that the patients are cured, not a single patient had any evidence of reoccurrence of their disease, with a follow-up range of one to six years.

Chronic lymphocytic leukemia accounts for about one third of all leukemias and is the most common leukemia in adults. The American Cancer Society estimates that 15,110 new cases of chronic lymphocytic leukemia were diagnosed in the United States during 2008. About 4,390 people in the United States died of chronic lymphocytic leukemia during 2008.

The trial concluded that FCR-Lite is highly effective in untreated chronic lymphocytic leukemia patients that have not yet been treated with another therapy regimen.

Dr. Foon said many patients with chronic lymphocytic leukemia have been treated with FCR, but it is extremely toxic to the bone marrow. FCR-Lite was specifically designed to maximize the combination of the same two chemotherapy drugs used in FCR, but in decreased doses and to maximize the dose of the less toxic monoclonal antibody rituximab.

"We showed that with FCR-Lite, we not only were able to achieve excellent responses in this patient population, possibly even improving responses over FCR, but we also saw a major reduction in the bone marrow toxicity as compared to FCR," Dr. Foon said.

Dr. Foon conducted the study at the University of Pittsburgh but will be opening his next FCR-Lite trial at NVCI in February 2009.

The Journal of Clinical Oncology, one of the most respected journals in the oncology field, selected Dr. Foon's paper for an editorial. The journal's publishers choose only three to four articles among 30 to 40 articles published per issue for editorial comment.

An abstract of the article can be found here.

"Chemoimmunotherapy With Low-Dose Fludarabine and Cyclophosphamide and High Dose Rituximab in Previously Untreated Patients With Chronic Lymphocytic Leukemia"
Authors: Kenneth A. Foon, Michael Boyiadzis, Stephanie R. Land, Stanley Marks, Anastasios Raptis, Louis Pietragallo, Dennis Meisner, Andrew Laman, Mathew Sulecki, Allyson Butchko, Patricia Schaefer, Diana Lenzer, and Ahmad Tarhini

About Nevada Cancer Institute

NVCI is accredited by The Joint Commission and is dedicated to patient healthcare quality and safety. A nonprofit organization, NVCI is committed to reducing the burden of cancer by pursuing the development of a cancer research institute, as defined by the National Cancer Institute. Through the knowledge and expertise of the finest scientists, clinicians, educators and caregivers, the Institute provides hope to communities in Nevada, the southwest and beyond through research, education, early detection, prevention and high quality patient care. For more information, please visit http://www.nevadacancerinstitute.org.

Nevada Cancer Institute

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