[New antitumor drugs for malignant lymphoma: a review]

We summarize here the antitumor activity of newly developed drugs against malignant lymphoma. Irinotecan hydrochloride (CPT-11) showed a CR rate of 15% and an excellent response (CR + PR) rate of 42% in patients with non-Hodgkin's lymphoma who had prior treatment. In patients with ATL, 13% achieved CR and a response rate was 39%. MST-16, a new orally administered bis(2, 6-dioxopiperazine) analogue, showed a CR of 3% and PR of 28% (response rate 31%), among patients with ATL, 9% of 23 patients achieved CR and the response rate was 44%. Phase I studies of fludarabine demonstrated a high response rate of 64%, especially in follicular lymphoma, with a number of patients achieving CR. Subsequent phase II studies demonstrated a response rate of 89% in patients with indolent lymphoma. KRN 8602 was developed in an attempt to improve the clinical efficacy of currently used anthracyclines. KRN 8602 has been shown to produce less cardiotoxicity and alopecia, yet has comparable antitumor effects to ADM, and also has demonstrated an antitumor effect on ADM-resistant tumors. CPT-11 and MST-16 were found effective not only in refractory non-Hodgkin's lymphoma, but also in patients with ATL, which had no standard therapy. Fludarabine has been demonstrated to be a very active drug in indolent lymphoid neoplasms, particularly CLL and low grade lymphoma. These new drugs are expected to overcome malignant lymphoma refractory to treatment thus far.