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Alert Number 189

Rituxan: the Shaving Reaction

Date: August 28, 2006

Rituxan is possibly the most important drug for CLL patient, at least for now. The “standard dose” of this monoclonal antibody is 375 mg/m2, given as an intravenous infusion once a week for 4 (or 8) weeks.

Did you know how they came up with that very scientific and precise number, 375mg/m2? Way back, when they were doing the first human trial with Rituxan, the researchers divided the amount of the drug they had available to them by the number of patients enrolled and voilà, that is how they came up with the number. Believe it, or not!

Well, it is time to figure out exactly how much Rituxan we should be getting. Too much of any drug can be toxic and in the context of the chimeric (half-mouse and half-human) protein drugs such as Rituxan, hypersensitivity reactions of the type “Harvey” had can be dose dependent. Dr. Ronald P. Taylor is one of my favorite researchers and he has suggested that when too much Rituxan is given too fast, all we end up doing is “shaving” off the CD20 marker on the CLL cells, making them that much harder to detect or kill. We may get better results if the drug is given as a simple subcutaneous injection that the patients can self-administer, and at tiny micro doses of 20 mg each time! Easy on your body, easy on your wallet, may even work better - what is not to like?

We are pleased and proud to announce CLL Topics is sponsoring and funding this important clinical trial; it examines the crucial issue of Rituxan dosage and the method of administration. The clinical trial will be conducted under the auspices of the NIH and the pivotal lab work will be done at the University of Virginia, under the guidance of Dr. Ron Taylor. The trial has just been announced and has started recruiting patients. You can read all about it in our article titled CD20 Shaving with Rituxan.

After all, it is your hard earned money that is paying for part of this trial!

Be well,

Chaya
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