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Treatment of B-cell lymphomas with anti-idiotype antibodies alone and in
combination with alpha interferon
SL Brown, RA Miller, SJ Horning, D Czerwinski, SM Hart, R McElderry, T Basham, RA Warnke, TC Merigan and R Levy
Department of Medicine, Stanford University School of Medicine, CA.
Idiotypes are distinct clonal markers for B-cell lymphomas. Previously we
reported the use of anti-idiotype antibodies in the therapy of patients
with B-cell malignancies. Because synergy was demonstrated with the
addition of alpha interferon to anti-idiotype antibodies in a murine
lymphoma model, we performed a clinical trial combining these two agents.
Here we provide an update of the original trial of anti- idiotype
antibodies alone and report the outcome of the new combination trial. In 16
treatment courses of anti-idiotype antibodies alone there were seven
partial responses and one complete response. In 12 courses of combination
anti-idiotype antibody and alpha interferon there were two complete
responses and seven partial responses. Substantial tumor regressions
occurred with minimal toxicity in both trials even in patients refractory
to conventional chemotherapy. Tumor specimens obtained at the time of
disease progression often contained a preponderance of idiotype-negative
lymphoma cells, suggesting that anti- idiotype antibody treatment exerted a
strong antitumor effect against antigen-positive cells. Anti-idiotype
antibodies have reproducible objective antitumor activity in B-cell
lymphoma. The addition of alpha interferon may improve the initial rate of
response to this treatment. Strategies that deal effectively with
idiotype-negative lymphoma cells should improve the extent and duration of
these responses.
Volume 73,
Issue 3,
pp. 651-661,
02/15/1989
Copyright © 1989 by The American Society of Hematology
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