New therapy for cancer after transplants

Immunochemotherapy for the treatment of cancer after organ transplantation

03/01/2012

After organ transplantation, up to 10 percent of patients contract cancer or a post-transplant lymphoma (PTLD). Scientists of the German PTLD Study Group at the University Hospital Schleswig-Holstein have developed a novel cancer therapy for those affected, with the help of which the chances of survival of those affected can be significantly increased.

The researchers around the head of the PTLD study group, Ralf Ulrich Trappe, report in the journal „Lancet Oncology“, sequential immunochemotherapy significantly increases patients' chances of survival and redefines the standard of care for the treatment of post-transplant lymphoma worldwide. According to the scientists, PTLD is the second most common malignant disease after organ transplantation and usually life-threatening for those affected.

Improvement of the clinical picture in 90 percent of the patients
According to researchers led by study group leader Ralf Ulrich Trappe, chemotherapy combined with the drug rituximab can provide long-term success in the treatment of PTLD. In an open-label Phase II study, scientists tested their sequential immunochemotherapy, achieving 90% of patients' long-term improvement in disease status. In 40 out of 59 patients (68 percent) the symptoms even went completely down. Given that estimates have seen the survival rates of PTLD patients at only 50 percent, the current study results are a groundbreaking success.

Sequential immunochemotherapy with numerous benefits
The special feature of the method of sequential immunochemotherapy by the scientists of the University Hospital Schleswig-Holstein is the combination of different therapeutic approaches. Thus, the tumors are treated in the run-up to chemotherapy with the monoclonal antibody rituximab, which attacks the CD20-positive B cells that make up many tumors. Patients will initially receive four treatments of rituximab before starting the four cycles of CHOP chemotherapy, the researchers report. In addition, an anti-infective therapy is carried out, consisting of the mandatory administration of certain medicines and possibly antibiotic prophylaxis, said study group leader Ralf Ulrich Trappe. According to the scientist, this method has distinct advantages, especially when compared to rituximab-based antibody therapy alone, as measured by response to therapy and overall survival. (Fp)

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