Targeted therapy for non-Hodgkin lymphoma
Targeted therapy drugs attack specific features of cancer cells to stop the cancer growing or to reduce its size.
Learn more about:
- What are monoclonal antibodies?
- Having monoclonal antibodies
- Side effects of targeted therapy
- Small molecule inhibitors
- Video: What is targeted therapy?
Some types of non-Hodgkin lymphoma are treated with a group of targeted therapy drugs called monoclonal antibodies.
The immune system makes proteins called antibodies to help fight infections. Monoclonal antibodies are manufactured versions of these natural antibodies. They target and attach to a protein found on cancer cells. This makes it easier for the body’s immune system to find and destroy the cancer cells. In non-Hodgkin lymphoma, different monoclonal antibodies may be used for different proteins.
For CD20 proteins – Rituximab and obinutuzumab are used when the protein CD20 is found on B-cell non-Hodgkin lymphomas. Newer drugs for CD20 are becoming available in Australia. These work in the same way and are known as biosimilar drugs. These drugs do not work for T-cell or NK-cell lymphomas.
For CD30 proteins – Brentuximab vedotin is used when the protein CD30 is found in some B-cell lymphomas and some T-cell lymphomas.
Other targeted therapy drugs for non-Hodgkin lymphoma may be available through clinical trials. Ask your doctor about the latest developments in targeted therapy for non-Hodgkin lymphoma.
Monoclonal antibodies are generally given through a drip into a vein. They are usually combined with chemotherapy and are commonly given in repeating cycles. Talk to your doctor about your specific treatment schedule.
Side effects of monoclonal antibody therapy
Your doctor will let you know of any potential side effects before you start treatment. Some people may have a reaction (e.g. nausea, skin rashes and itching) during treatment or several hours after having these drugs. The risk of these reactions declines with every dose and is rare after the first dose. You will probably be given medicine to help prevent such a reaction and you will have regular check-ups during treatment.
Other side effects can include headache, fatigue, anaemia, flu-like symptoms and an increased risk of abnormal bleeding.
In some people, rituximab can reactivate some viral infections, such as hepatitis B. It can also increase your risk of getting another infection. It is important to discuss any side effects with your doctor immediately. If left untreated, some symptoms can become life-threatening.
Small molecule inhibitors
Small molecule inhibitors are another type of targeted therapy. These drugs can get inside cancer cells and block certain enzymes that tell the cancer cells to grow.
Small molecule inhibitors such as ibrutinib, idelalisib and venetoclax are used to treat some types of low-grade lymphoma that have not responded to treatment or have come back. In some cases, small molecule inhibitors might also be an option if you are older.
Talk with your doctor about whether these treatments (or another drug available on a clinical trial) are suitable for your situation.
These drugs have the potential to cause a variety of side effects – your doctor will discuss these with you before you start treatment.
Video: What is targeted therapy?
Watch this short video to learn more about targeted and immunotherapy.
Podcast: Immunotherapy & Targeted Therapy
A/Prof Christina Brown, Haematologist, Royal Prince Alfred Hospital; Khaled Aly, Consumer; Kevin Bloom, Senior Social Worker, Haematology and Bone Marrow Transplant, Royal North Shore Hospital; Katrina Debosz, CAR-T and Lymphoma Nurse Practitioner, Royal Prince Alfred Hospital; Dr Samuel Dickson, Radiation Oncologist, Calvary Mater Newcastle; Dr Wojt Janowski, Haematologist, Calvary Mater Newcastle; Yvonne King, 13 11 20 Consultant, Cancer Council NSW; Karen Maddock, Blood Transplant and Cell Therapy Nurse Practitioner, Westmead Hospital; Sheridan Wellings, Consumer.
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