Gary Lyman, MD, MPH, of the Fred Hutchinson Cancer Research Center and Seattle Cancer Care Alliance, discusses how biosimilar rituximab may be used in cancer care.
Well again that's yet to be seen. Of course we do have a biosimilar rituximab as you allude to. It’s now approved in the United States, and it’s actually been in Europe for a longer period of time, so we have some experience there, and in fact as last year's [American Society of Clinical Oncology, ASCO] meeting last June, a European group presented data on the early utilization of rituximab in patients with lymphoma in Europe.
What was interesting there, and I think we may see the same thing happen here in the United States, is the utilization of the biosimilar rituximab was more favorable in patients with less curable forms of lymphoma. In other words, the oncologist was willing to use these new agents in a situation where the goal wasn't necessarily long-term survival or cure. They reserved the originator, Rituxan, for use in patients with, for instance, diffuse large B-cell lymphoma where the goal of treatment is usually cure.
There’s some discrimination in the use of that, which is perhaps understandable because this is not just supportive care. This is the mainstay of treatment for these patients, and if you're treating for curative intent, do you really want to take any chances if you're not quite sure, or if you haven't used the drug before?
So you’re more likely to use it in solid tumors in patients with metastatic disease perhaps or lymphoma with the low-grade lymphomas where your goal is extending life but not so much the likelihood of curability.
That’s data from Europe, but my guess is we're going to see a similar kind of gradual intake and then over time broad utilization across the subtypes of lymphoma.