A treatment protocol tested in B.C. for all patients with the most common type of non-Hodgkin lymphoma has increased patient survival rates by 50 percent, shows a new BC Cancer Agency study published today in the Journal of Clinical Oncology.

Since the 1970s, diffuse large B-cell lymphoma (DLBCL) had been treated with a combination of chemotherapies known as CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone). In 2000, the Groupe d'Etude des Lymphomes de l'Adulte in Europe showed that adding another drug called rituximab helped improve survival rates in patients over 60 years old.

Based on this new evidence, in 2001 the BC Cancer Agency, an agency of the Provincial Health Services Authority, began combining CHOP with rituximab not just for older patients, but for all newly-diagnosed patients with advanced-stage DLBCL, regardless of age.

As one of the first organizations to provide this therapy universally to DLBCL patients, the BC Cancer Agency was able to evaluate its effectiveness for all patients, and not just those in the controlled environment of a clinical trial, says Dr. Laurie Sehn, a BC Cancer Agency oncologist and principal author of the paper.

"The particular value of this study is that it reflects the impact of a new treatment combination in all patients, not just in patients enrolled in randomized clinical trials," explains Dr. Sehn. "We have seen a substantial, beneficial outcome as a result of this treatment policy. This study really documents the vast improvement we see across all the patients with this disease in B.C."

To determine whether this treatment protocol was making a difference in BC Cancer Agency patients, the researchers followed the DLBCL patients through the BC Cancer Agency Lymphoma Outcomes Unit recording diagnostic, treatment and outcome information.

The results were dramatic: prior to adding rituximab to CHOP, about 50 percent of patients survived more than two years; the data from this study show that this new treatment policy has improved the survival rate to 75 percent – an increase of 50 percent.

The BC Cancer Agency is one of the only organizations in the world that could complete this study, explains Dr. Joseph Connors, head of the Lymphoma Tumour Group at the BC Cancer Agency, thanks to its population-based approach to cancer care and ability to follow patient outcomes past the completion of treatment.

"This is the first study of the impact of introducing this treatment protocol for an entire population, and the only one published to date because few other organizations have the capacity to do this kind of research," says Dr. Connors. "BC Cancer Agency was the first to offer rituximab with CHOP in Canada, and the first to offer it to patients of all ages."

Recognizing the value of this treatment protocol is particularly important due to the relative increase in non-Hodgkin lymphoma cases, says Dr. Connors. Currently, about 100 people per year in B.C. are diagnosed with the disease.

"Non-Hodgkin lymphoma is the fastest-growing common cancer in terms of new cases each year," he explains. "It's therefore really valuable to find a treatment that reduces mortality by such a substantial amount."

Support for this study was made possible by the Turner Family Lymphoma Outcome Unit Fund, the Yvette Porte Lymphoma Research Endowment, and Roche Canada Inc.

The BC Cancer Agency, a part of the Provincial Health Services Authority, is committed to reducing the incidence of cancer, reducing the mortality from cancer, and improving the quality of life of those living with cancer. It provides a comprehensive cancer control program for the people of British Columbia by working with community partners to deliver a range of oncology services, including prevention, early detection, diagnosis and treatment, research, education, supportive care, rehabilitation and palliative care. The BC Cancer Research Centre conducts research into the causes and cures for cancer.

For information, or to arrange an interview, please contact:
Nicole Adams
Public Relations Officer
BC Cancer Agency
604.877.6272
nadams@bccancer.bc.ca