Non-Hodgkin Lymphoma: Targeted Therapy
What is targeted therapy?
Targeted therapy is the use of medicines that target parts of cancer cells that make them unlike normal cells. Targeted medicines for non-Hodgkin lymphoma work on genes and proteins in lymphoma cells. The medicines are different from standard chemotherapy medicines. They may work when chemotherapy medicines don’t. And they have different side effects.
When is targeted therapy used for non-Hodgkin lymphoma?
The medicines can be used to treat some types of non-Hodgkin lymphoma. The medicines are used most often after other treatments have been tried. But some targeted medicines are now being studied for earlier use.
What are the types of targeted therapy medicines?
The targeted medicines used to treat non-Hodgkin lymphoma include:
HDAC (histone deacetylase) inhibitors
Kinases are proteins in cells that help send signals to the control center inside the cell. Some kinases help lymphoma cells grow or stay alive. Medicines that block these kinases are known as kinase inhibitors. They can help slow or stop the growth of some types of lymphoma cells.
Ibrutinib blocks a protein called BTK that normally helps B-cells grow and develop. This medicine can be used to treat mantle cell lymphoma and some other lymphomas. It is taken daily as a pill. Side effects can include nausea, vomiting, loss of appetite, changes in bowel movements, feeling tired, and low blood cell counts.
Idelalisib blocks a kinase known as PI3K. This medicine can be used to treat follicular lymphoma and some other lymphomas. It is taken as a pill, often twice a day. Side effects can include fever, feeling tired, nausea, diarrhea, cough, belly pain, rash, and low blood cell counts.
Proteasomes act like tiny garbage disposal units inside cells. They get rid of unwanted proteins. This can affect cell growth. Medicines that block proteasomes can be used to treat some types of lymphoma. One medicine is called bortezomib. The medicine can be given through an IV (intravenous line) into a vein or underneath the skin (subcutaneously). Side effects can include nausea, loss of appetite, and low blood cell counts. Nerve damage can also occur. This can lead to numbness, tingling, or pain in the hands and feet.
HDAC inhibitors are medicines that affect histones. These are proteins that affect the genes in our cells, which can alter how the cells grow. HDAC inhibitors can be used to treat some types of T-cell lymphomas, including skin lymphomas. These medicines include romidepsin and belinostat. These medicines are given through an IV into a vein. Side effects can include nausea, vomiting, feeling tired, and low blood cell counts.
September 23, 2017
NCCN Clinical Practice Guidelines in Oncology: Non-Hodgkin's Lymphomas Version 2.2015. National Comprehensive Cancer Network
Alteri, Rick, MD,LoCicero, Richard, MD