Rituxan is prescribed in three ways and it is not consistent throughout the country. Here is a fact sheet that outlines what provinces fund Rituxan therapy.
Rituxan was the first monoclonal antibody approved for use (1997 in the United States, 2000 in Canada). It is widely used in combination with traditional chemotherapy for most types of lymphoma. Below is a chart (Figure 1) that outlines the three main ways Rituxan is used in Canada and for what types of lymphoma.
Please note that each case of lymphoma is unique, and as such, we strongly recommend you always consult your physician with any question you may have about these treatments.
Figure 1: Overview
Rituxan First-Line
Rituxan Maintenance
Rituxan Retreatment
A first-line treatment is recommended for the initial treatment of lymphoma.
The combination of Rituxan with chemotherapy has shown to prolong remission in many types of lymphoma, and in patients with diffuse large B-cell lymphoma, it has shown to improve survival.
Maintenance treatment refers to therapy used within the first 6 months following initial treatment in an attempt to keep lymphoma from progressing or recurring.
Data has shown that relapses can be delayed, or even prevented, by continuing or ‘maintaining’ treatment with Rituxan while patients are in remission.
The goal of maintenance therapy is to prevent those patients who have responded to initial treatment from relapsing while ultimately improving overall survival.
Retreatment refers to a second course of Rituxan after a patient has relapsed.
Retreatment therapy has not yet been applied for in Canada.
It is used in many other developed countries.
Used for the following lymphoma’s:
• patients with relapsed or refractory* low-grade or follicular, CD20 positive,
B-cell non-Hodgkin’s lymphoma
• patients with CD20 positive, diffuse large B-cell non-Hodgkin’s lymphoma in combination with CHOP chemotherapy (cyclophosphamide, doxorubicin, vincristine, and prednisone)
• patients with previously untreated Stage III/IV follicular, CD20 positive, Bcell
non-Hodgkin's lymphoma in combination with CVP (cyclophosphamide, vincristine and prednisone) chemotherapy
• patients with follicular lymphoma or other indolent B-cell lymphomas
• patients with follicular non-Hodgkin’s lymphoma who have
responded to induction therapy with either CHOP or CHOP plus Rituximab and it must be administered within 6 months of their initial treatment
•patients with follicular non-Hodgkin’s lymphoma who have
responded to induction therapy with either CHOP or CHOP plus Rituximab
• patients with CD20 positive relapsed or refractory*, low grade, follicular, or transformed non-Hodgkin's lymphoma, including patients with Rituximab-refractory* NHL
Approved for funding in all provinces
See funding breakdown in Figure 2
*refractory - means resistant to treatment or not yielding to treatment
Figure 2:
Rituxan Retreatment Funding - Provincial Breakdown as of January 2008
Diffuse Large B-Cell Lymphoma
Approved: + Nova Scotia + Newfoundland
+ Newfoundland
Case by Case:
Ø British Columbia Ø Alberta Ø Manitoba Ø Quebec Ø New Brunswick Ø Prince Edward Island
Ø Alberta Ø Manitoba Ø Quebec Ø New Brunswick Ø Prince Edward Island
Ø Manitoba Ø Quebec Ø New Brunswick Ø Prince Edward Island
Ø Quebec Ø New Brunswick Ø Prince Edward Island
Ø New Brunswick Ø Prince Edward Island
Ø Prince Edward Island
Not Approved:
x Saskatchewan x Ontario
x Ontario
Indolent Lymphoma
Approved:
+ Nova Scotia + Newfoundland + Alberta + Manitoba
Ø British Columbia Ø Quebec Ø New Brunswick Ø Prince Edward Island
Remember, every patient has the right to ask about their type of lymphoma and the prescribed treatment plan.
If you would like information on possible financial support for therapies that may not be covered in your province, please click here. If you would like a sample letter to send to your provincial government click here. To get the contact information for your provincial government click here.
