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RIT First
So if RIT is so great, can it be used as the first treatment? As mentioned earlier, Zevalin is FDA approved for use in combination with chemotherapy as front-line treatment, or it can be used alone after initial therapy. As front line therapy, Bexxar is not yet approved alone or in combination with chemotherapy. It has only been approved for use after initial therapy.
But there's more to this story. Once a drug is approved by the FDA, physicians can use it “off label,” meaning that they can use it for purposes other than that for which it was approved. Rituxan, with which almost all chemotherapy is combined, is a great example. Rituxan was first approved in 1997 for use by itself after an initial treatment failed. Almost immediately, physicians began combining Rituxan with chemotherapy and the results were good for patients, but it wasn’t until 2006 that Rituxan was approved for use in combination with a common chemo known as CVP for patients with follicular lymphoma. That same year, it was also approved for use with another common chemo called CHOP, but only in patients with diffuse large B cell lymphoma. Yet patients with follicular lymphoma commonly receive CHOP with Rituxan – a perfect example of “off label” use. It's estimated that about 70% of cancer drugs are, in fact, used off label and patients routinely benefit from such use.
In the case of RIT, however, it can be challenging to find oncologists who are familiar with it, much less to find one willing to use it as the single initial treatment – and it would require convincing your insurance provider to pay for it off label. However, it has been done so there is precedent. In fact, you can read the entire entertaining and informative story about one man who took Bexxar as his first and only treatment. His name is Tony Hines, but he is affectionately known as “Bexxar Boy” in the lymphoma community. Click here to read his story.
Whatever you decide, my best advice is to be proactive in your health care. If you don’t feel up to the task, ask a friend or family member for help. Above all, remember that it’s your body and the treatment you choose is ultimately your decision.
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