Treatment for People Who Have Relapsed
- In July 2020, the FDA approved the drug combination of Monjuvi plus Revlimid for people with diffuse large B-cell lymphoma that had returned or didn’t respond to previous treatments
- A clinical trial showed that 55% of people who tried this treatment had a complete or partial response
- Side effects include infusion site reactions, low blood cell counts, fatigue, and diarrhea
Monjuvi is a monoclonal antibody, similar to rituximab (Rituxan), which is part of the R-CHOP regimen. “Most lymphoma patients are familiar with rituximab, which is an anti-CD20 antibody that was approved by the FDA back in 1997,” Dr. Jakub Svoboda, medical oncologist at Penn Medicine, tells SurvivorNet. The difference is that, instead of CD20, Monjuvi targets and attaches to CD19, another protein on the surface of B cells. When it binds to this protein, Monjuvi triggers the death of the cancer cell.
Read MoreHow Well Does Monjuvi Plus Revlimid Work?
In a clinical trial of more than 70 people with diffuse large B-cell lymphoma lymphoma who had already tried oneto three other treatments, 60% of patients responded to treatment and this response lasted for nearly
22 months. Among these patients, 43% was a complete response, meaning they had no evidence of
cancer on imaging scans and 18% had a partial response to treatment, which is partial shrinkage of the
tumor. “The response rates shown in the study are remarkable,” says Dr. Sairah Ahmed, associate professor in the Department of Lymphoma/Myeloma, Division of Cancer Medicine at MD Anderson Cancer Center. “This agent helps bridge a gap for patients who have disease that has relapsed after initial response to chemotherapy.”
How Do You Get This Treatment?
Your health care provider will give you Monjuvi intravenously directly into a vein. You'll get this
medication which is weekly for the first month further every other week. Revlimid is taken as a pill by
mouth, on a specific cycle. Typically, each cycle lasts about 28 days. The treatment is given for up to
12 cycles, or until the cancer progresses or side effects become too much to tolerate.
What are the Side Effects?
Overall, this drug combination is “fairly well tolerated,” Dr. Ahmed says. The most common side effects are:
- Reactions at the infusion site
- Low blood cell counts
- Tiredness
- Diarrhea
- Cough
- Fever
- Limb swelling
- Upper respiratory infection
- Decreased appetite
This treatment can also cause more serious side effects, such as bone marrow suppression and infections, and it may be harmful to a developing baby when given during pregnancy. Ask your doctor before you get Monjuvi plus Revlimid what side effects to expect, and what you can do to manage them.
New Hope
Treatments like Monjuvi are offering new possibilities for people who haven’t had success with the first lymphoma treatments they’ve tried. This therapy “gives us hope that, even for patients who failed previous treatments, we will have an option that will result in long term response,” Dr. Svoboda says. “Having a growing number of therapies with different mechanisms of action will allow us to tailor more effective and less toxic treatments right from the time of lymphoma diagnosis.”
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