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For some subtypes of non-Hodgkin lymphoma, you may get a targeted therapy. This is more exact than standard chemotherapy, which affects all fast-growing cells in the body. Small molecule inhibitors are a type of targeted therapy.
Non-Hodgkin Lymphoma Care Tailored to You
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What are small molecule inhibitors?
Small molecule inhibitors work by blocking a biological process that drives tumor growth. They work differently than standard chemotherapy: Instead of killing all fast-growing cells or keeping them from dividing, small molecule inhibitors work more selectively against cancer cells that rely on a specific growth-promoting protein or process.
There are several enzymes or biological processes that these drugs may inhibit:
- They block proteins known as kinases (a type of enzyme) from doing their job
- They prevent cells from breaking down proteins using the proteasome
- They block the activity of enzymes that modify DNA packaging proteins (histone deacetylase inhibitors or EZH2 inhibitors)
- They prevent cells from moving proteins out of the nucleus
- They block proteins that prevent programmed cell death
How Small Molecule Inhibitors Can Treat Non-Hodgkin Lymphoma
Small molecule inhibitors make it harder for cancer cells to carry out key processes that keep them alive and growing. Examples of small molecule inhibitors:
- Bortezomib
- Belinostat
- Ibrutinib
- Acalabrutinib
- Zanubrutinib
- Pirtobrutinib
- Venetoclax
- Duvelisib
- Tazemetostat
Many options are available, and the list keeps growing as researchers develop and test new ones.
As with chemotherapy, your small molecule inhibitor will be prescribed by your hematologist-oncologist. They can be used alone or with other treatments.
Small molecule inhibitors are used for many subtypes of NHL, including:
- Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL)
- Diffuse large B-cell lymphoma (DLBCL)
- Peripheral T-cell lymphoma
- Follicular lymphomas
- Waldenström macroglobulinemia (lymphoplasmacytic lymphoma)
Why Choose Fred Hutch for Targeted Therapy for Non-Hodgkin Lymphoma
Hematologist-oncologists at Fred Hutch are experts in all forms of medicine to treat cancer, including the latest small molecule inhibitors. They know how to choose and combine drug options to match your needs. Besides standard therapies, we often have clinical trials testing new drugs or new drug combinations for NHL. So, we are able to offer you therapies that aren’t offered everywhere.
Your hematologist-oncologist partners with the rest of your Fred Hutch care team. They work closely with your radiation oncologist and pathologist. They design a treatment plan for you to target your disease and have the least impact on healthy tissue. Your hematologist-oncologist also works closely with you to manage any side effects from medicine-based treatments. Your whole team helps you take the best possible care of yourself.
The side effects of small molecule inhibitors depend on which therapy you receive. Common side effects include:
- Nausea, vomiting, diarrhea or loss of appetite
- Headache
- Fatigue
- Joint or muscle pain
- Cough
- Rash
- Increased risk of infections
- Easy bruising or bleeding
If your Fred Hutch care team recommends a small molecule inhibitor, we’ll explain what to expect based on the medicine you’re getting.
Your care team at Fred Hutch is here to help you prevent or prepare for side effects and to relieve any side effects you have. The most important step you can take is to let your team know what you’re feeling. We’ve helped many patients and families through this process and know ways to ease your experience.
Often, there are medicines to help, like anti-nausea drugs. Based on the side effect, there may be a range of other helpful options too, like diet changes, physical therapy and emotional and practical support. We also offer integrative medicine, including acupuncture. Fred Hutch researchers continue to look for the best ways to keep side effects at bay.
Your care team at Fred Hutch will explain your treatment schedule. We’ll also talk with you about the recovery process, like how long you can expect side effects to last.