Patients with previously treated follicular lymphoma now have a new treatment option that is free from the side effects of chemotherapy, as well as giving fresh hope to those who have built resistance to existing medicines.

The new drug, lenalidomide (Revlimid, Celgene) has been approved by NICE. It fights cancer cells in a different way to current treatments, interfering with cell processes to halt the growth of tumours and stopping them from producing their own blood vessels.

Lenalidomide has been recommended for use with rituximab (MabThera, Roche), an anti-CD20 antibody that sticks to cancer cells to help the immune system recognise and kill them.

Rituximab is often used alongside chemotherapy as the standard treatment for follicular lymphoma. It’s thought that around one in five patients relapses from rituximab with chemotherapy within two years of treatment.

New type of targeted cancer therapy

Meindert Boysen, director of the Centre for Health Technology Evaluation at NICE, said: “Lenalidomide is a new type of targeted cancer therapy for people with previously treated follicular lymphoma. It not only offers patients a chemotherapy-free treatment option, but it also benefits those whose disease has become resistant to chemotherapy or rituximab. Lenalidomide fights cancer cells in a different way to current treatments which should help reduce resistance and improve disease outcomes.

“The use of lenalidomide with rituximab is more toxic to cancer cells than the singular use of either drug. Importantly, patients have also been seen to overcome previous resistance to rituximab when it’s taken with lenalidomide.

“We’re therefore pleased to be able to recommend the use of lenalidomide with rituximab on the NHS, as an alternative treatment for people with previously treated follicular lymphoma.”

Clinical trial evidence shows that taking lenalidomide with rituximab increases the length of time before the disease progresses by around 39.4 months, compared to around 13.8 months when taking rituximab alone. Company estimates suggest around 900 people would be eligible for treatment.

Lymphomas are cancers of the lymphatic system, a key player in the body’s immune response. Follicular lymphoma is a slow growing type of non-Hodgkin’s lymphoma. It forms when B-cells, the white blood cells that fight infections, become abnormal. Lymphomas are commonly staged 1 (best prognosis) to 4 (worse prognosis).