Targeted Therapy Drugs for Non-Hodgkin Lymphoma

As researchers have learned more about the changes in cells that cause cancer, they have been able to develop newer drugs that specifically target these changes. These drugs are often referred to as targeted therapy. These drugs work differently from standard chemotherapy (chemo) drugs and often have different (and less severe) side effects.

Proteasome inhibitors

Proteasome inhibitors work by stopping enzyme complexes (proteasomes) in cells from breaking down proteins important for keeping cell division under control. They are more often used to treat multiple myeloma, but can be helpful in treating some types of non-Hodgkin lymphoma, as well.

Bortezomib (Velcade) is a proteasome inhibitor that is used to treat some lymphomas, usually after other treatments have been tried. Bortezomib is given as an infusion into a vein (IV) or an injection under the skin (sub-q), typically twice a week for 2 weeks, followed by a rest period. Side effects can be similar to those of standard chemo drugs, including low blood counts, nausea, loss of appetite, and nerve damage.

Histone deacetylase (HDAC) inhibitors

HDAC inhibitors are a group of drugs that can affect what genes are active by interacting with a protein in chromosomes called histone.

Romidepsin (Istodax) is an HDAC inhibitor that can be used to treat both peripheral and skin T-cell lymphomas. It is usually given after at least one other treatment has been tried. This drug is given as an IV infusion, usually once a week for 3 weeks in a row, followed by a week off. Side effects tend to be mild, but can include lowered blood cell counts and effects on heart rhythm.

Belinostat (Beleodaq) is another HDAC inhibitor. It is given to treat peripheral T-cell lymphomas, usually after at least one other treatment has been tried. It is given as an IV infusion, usually daily for 5 days in a row, repeated every 3 weeks. Common side effects include nausea, vomiting, tiredness, and low red blood cell counts (anemia).

Kinase inhibitors

Ibrutinib (Imbruvica) is a type of drug known as a kinase inhibitor. It blocks a protein that transmits a signal to some lymphoma cells that helps them grow and survive. It can be used to treat mantle cell lymphoma. This drug is taken by mouth, once a day. Common side effects include diarrhea or constipation, nausea and vomiting, fatigue, swelling, decreased appetite, and low blood counts. Although this drug is approved for use in patients after other treatments have been tried, it is being studied for use earlier in treatment.

Idelalisib (Zydelig) is another kinase inhibitor that can be used to treat NHL, although this one blocks a different kinase (called PI3K). This drug has been shown to help treat follicular lymphoma and small lymphocytic lymphoma after other treatments have been tried. It is taken as a pill twice a day. Common side effects include diarrhea, fever, fatigue, nausea, cough, pneumonia, belly pain, chills, rash and low blood counts. Less often, more serious side effects can also occur.

More information about the kinds of drugs considered targeted therapy can be found in Targeted Therapy.

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Our team is made up of doctors and master’s-prepared nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Freedman AS, Jacobson CA, Mauch P, Aster JC. Chapter 103: Non-Hodgkin’s lymphoma. In: DeVita VT, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2015.

Roschewski MJ, Wilson WH. Chapter 106: Non-Hodgkin Lymphoma. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 5th ed. Philadelphia, Pa: Elsevier; 2014.

 

Last Medical Review: August 26, 2014 Last Revised: February 29, 2016

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