We have good news for those facing
refractory follicular lymphoma : a new drug offers more hope. While confronting this form of cancer is profoundly challenging, it's crucial to know that you're not alone. The approval of new treatments like zanubrutinib with obinutuzumab represents a significant step forward in the fight against refractory follicular lymphoma. SurvivorNet is dedicated to supporting you with vital information and guidance, helping you navigate these difficult times with the latest advancements in treatment.
Understanding Refractory Follicular Lymphoma
There are more than 30 different types of
non-Hodgkin lymphoma , but some are a lot more common than others. Follicular lymphoma is the most common type of indolent — or slow-growing — lymphoma, accounting for 20 to 30% of all non-Hodgkin lymphoma cases. This type of non-Hodgkin lymphoma occurs when B lymphocytes (a type of white blood cell that fights infection) become abnormal. The abnormal cells usually build up in the lymph nodes, but can affect other areas of the body as well. "
Follicular lymphoma is a somewhat confusing disease to many patients and general oncologists, because it's cancer arising from a B-cell lymphocyte, but it can be very, very indolent, which means that the cells are dividing very slowly," says
Dr. Jakub Svoboda , a hematology specialist at Penn Medicine. "Refractory" follicular lymphoma refers to cases where the cancer does not respond to standard treatments or returns after initial success. This can be particularly disheartening, but recent medical advancements offer new hope.
Recent Breakthrough in Treatment
On March 7, 2024, the
U.S. Food and Drug Administration (FDA) approved a new treatment combination specifically for patients like you, who have tried at least two other treatments without success. This new option includes a medication called zanubrutinib (brand name
Brukinsa ), taken alongside another drug named obinutuzumab (brand name
Gazyva ).
What is Brukinsa?
Zanubrutinib belongs to a class of medications called
kinase inhibitors , which are highly targeted medications that can target and eliminate cancer cells while relatively sparing normal tissue, unlike chemotherapy. It inhibits Bruton's tyrosine kinase (BTK), which is a protein expressed on the surface of certain white blood cells (WBCs). Zanubrutinib, or Brukinsa, was designed to block BTK signaling and keep it shut down around the clock. It has been shown to block 100% of BTK in blood cells and 94% to 100% of BTK in lymph nodes when taken at the recommended total daily dose of 320 mg. It also plays a crucial role in the development and survival of normal WBCs. It also promotes the growth of cancer cells in leukemias and lymphomas. BTK inhibitors bind to the BTK proteins, preventing them from supporting cancer cell growth.
The Study Behind the Approval
This approval was based on a study called
ROSEWOOD , which involved 217 adults with your condition. The participants were given either the combination of zanubrutinib and obinutuzumab or just obinutuzumab by itself. Those who received both medications showed better results compared to those who received only one. In this study, 69% of patients receiving both medications saw their cancer respond to the treatment, and this response lasted longer than expected. In fact, the exact duration of how long the treatment remains effective couldn't be determined during the study period, which is a positive sign of its effectiveness.
What to Expect from the Treatment
Zanubrutinib is an oral
treatment that can be prescribed on a dosing schedule that meets your needs. It can be taken either once daily (4 capsules) or twice daily (2 capsules in the morning and 2 capsules later in the day). However, for the treatment of follicular lymphoma, it must be taken with obinutuzumab. Obinutuzumab is an intravenous infusion given in cycles that must be administered at a clinic or infusion center. Your doctor will talk to you about the infusion schedule for obinutuzumab.
Side Effects
The main side effects observed in the study included lower counts of neutrophils (a type of white blood cell) and platelets, infections of the upper respiratory tract, bleeding, and musculoskeletal pain. Bleeding problems are common with Brukinsa, and can be serious and may lead to death. Your risk of bleeding may increase if you are also taking a blood thinner medicine. It's important to discuss these potential side effects with your doctor to manage them effectively. You have to tell your healthcare provider if you have any signs or symptoms of bleeding, like:
- blood in your stools or black stools (looks like tar)
- pink or brown urine
- unexpected bleeding, or bleeding that is severe or you cannot control
- increased bruising
- dizziness or weakness
You Are Not Alone
While the physical impact of refractory follicular lymphoma is significant, the
emotional and psychological impacts are equally important to address . It’s crucial to reach out to support groups, health care teams, and loved ones for emotional and practical support. These networks can provide invaluable aid and comfort as you navigate your treatment options and daily challenges. Remember, every step forward in treatment and care is a step closer to managing your health better. SurvivorNet is here to support you in every aspect of your journey.
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