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Alert Number 51

New Rituxan Combination in the News

Date: October 15, 2004

This is one of those good-news/bad-news stories. Let me hasten to add, the bad news is not so bad, and the good news is quite good!

Topics Alert Number 49 identified another warning issued by the drug industry. This latest is the warning regarding the risk of hepatitis B virus reactivation during Rituxan therapy, and the need for taking preemptive medications if you have been exposed to hepatitis B. This is not good news, but it is not the end of the world either, just one more thing to remember and track.

On a positive note, the latest article on Topics, Rituxan in the News examines a promising new combination therapy with Rituxan and Fenretinide. We review the latest article in Blood authored by researchers at the "Hutch" in Seattle, which describes very nice synergy between Rituxan and Fenretinide: improved response without adding to the toxicity bill. How do you like them apples?

Fenretinide is an analogue of Vitamin A. This new potential Rituxan side-kick is already commercially available, and has a demonstrated record of very little toxicity in human trials. Not much stands in the way of a clinical trial with this new Rituxan combination, if we can only get moving on it! Combinations such as this may be the "Goldilocks" solution for those of us who think Rituxan monotherapy is too light and chemotherapy combinations such as RF and FRC are too heavy. Fenretinide is not the only one, we should also be keeping an eye on other small molecule drugs we have discussed in recent weeks, such as Adaphostin and the Celebrex-derived OSU03012. Right now the biggest problem with Rituxan is its inability to resolve large lymph nodes or heavily compromised bone marrow. Part of this problem is due to the inability of the bulky Rituxan molecule to reach all the locations of the tumor, and this is where small molecule drugs such as the ones I mentioned above may come in handy.

There is a clock ticking and no one hears its tick-tock louder than we do. I hope more of you will decide it is time to start getting informed, involved and ready to influence the development of these important therapy choices. Our lives depend on your decision.

Be well,


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