Is Gazyva chemo?

[flowerchild28]

Is Gazyva chemo? I have been told yes I have been told no.

[DRM18]

No, it’s a monoclonal antibody. (Yes, I looked that up just now. No, I don’t know what it means. )

I had it, 9 infusions of it, this year. No side effects, pleasant experience, awesomely rapid action!

[Smith123456]

Because it's an infusion it get's confused. It is not a 'classic chemo drug'. It's a 'novel' targeted drug. Because it's mixed then given as 4 hour infusion it's billed to major medical part of my medicare advantage plan and not part d. However 90 percent of a doctor's office staff or hospital will consider it and say chemo drug because they don't understand this stuff. Usually only the physicians and the pharmacist's dispensing it realize this.

[lankisterguy Volunteer]

Hi flowerchild28,

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I agree with DRM18 and Smith123456 . Most experienced CLL doctors don't call it Chemotherapy, but some less precise folks (and insurance companies) consider all cancer treatment as Chemotherapy.

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Gazyva / Obinutuzumab is considered Immunotherapy - usually by an infusion delivery, like Rituxan / Rituximab

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Here a link to a site that explain the difference,

cancer-champions.com/chemot...

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That site also mentions Targeted / Kinase / Checkpoint Inhibitor therapy, which is often a oral pill taken one or more times per day, and is also NOT Chemotherapy.

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Len

[Hidden]

I’m currently in the first month of receiving Gazyva by infusion at the hospital. Gazyva is a monoclonal antibody (you can tell this because of the ‘MAB’ in the obinutuzuMAB), and MAB is a type of targeted therapy. The American Cancer Society says that targeted therapy is technically considered chemotherapy, their explanation is here cancer.org/treatment/treatm...

The nurses at the hospital kept referring to it as ‘chemo’. It even got to the point that I asked them to confirm that I wasn’t in fact receiving chemo-I was worried I was getting the wrong drug!

So I think the answer is very confusing and technical and is actually ‘yes’ and ‘no’. 🤷🏻‍♀️

[flowerchild28 in reply to Hidden]

Thank you so much )

[Hidden]

My nurses have always worn the extra ‘chemo’ PPE when giving me Gazyva-might come down to hospital standards, professional/statutory requirements etc. There’s a practical and technical element as to whether it is/isn’t chemo.

[MsLockYourPosts Passed Volunteer in reply to Hidden]

I've had nurses wear chemo PPE when starting IVIG, which definitely isn't chemo. These days, due to the shortage of protective garb, one nurse is the designated "chemo nurse" and that nurse does anything involving handling the actual infusion.

[WinJ3]

OK...let me make this more confusing:

Gazyva is the trade name for the generic chemotherapy drug obinutuzumab.

Obinutuzumab is an anti-cancer ("antineoplastic" or "cytotoxic") chemotherapy drug.

Obinutuzumab is classified as a "monoclonal antibody"

chemocare.com/chemotherapy/...

😐

[Smith123456 in reply to WinJ3]

insurance drug plans don't have categories for'novel drugs'. they generally put them under the category of cancer drugs-ergo neoplastics or cytoxic or any other cancer drug category. you are correct-Gazyva is a brand name. obintuzamab is the chemical(generic) name

[AussieNeil Partner Founder Admin in reply to WinJ3]

The link provided by Hidden differentiates Obinutuzumab from traditional chemotherapy fairly well.

"Because of their targeted action, these drugs have an effect on the cancer cells and mostly leave normal, healthy cells alone. Traditional chemotherapy is cytotoxic to most cells, meaning it can damage normal, healthy cells in addition to damaging and killing cancer cells."

So, a good way to understand the difference between Obinutuzumab and traditional chemotherapy, is to consider how its precursor, Rituximab, was used with the traditional CLL treatments BR and FCR (Bendamustine+Rituximab and Fludarabine+Cyclophosphamide+Rituximab). Rituximab was the first generation CLL immunotherapy drug, which targeted cells expressing CD20 markers, that is mostly B-Lymphocytes and thus CLL cells. Obinutuzumab is a second generation CD20 monoclonal antibody. FCR and BR are technically termed chemoimmunotherapy treatments. As the reference notes, the FR and B chemotherapy drugs are not targeted, "meaning (they) can damage normal, healthy cells in addition to damaging and killing cancer cells." That is the fundamental difference. Obinutuzumab is still cytotoxic (toxic to cells), but it specifically only targets cells expressing CD20 on the cell membrane. It works in the same way our immunoglobulins/antibodies target bacteria, viruses and fungi, only it targets B-cells, including CLL cells, plus to a limited extent, a few other body cells (T-cells), that also slightly express CD20.

In this community we consider it "Non-Chemo".

Neil

[Hidden in reply to AussieNeil]

I think your last statement regarding this community hits the nail on the head Neil. We ‘laymen’ would hear chemo from our doctor and think hair loss, being ill etc. so our doctors generally won’t say it’s chemo to us (even if technically it’s defined as such). Like that link says, technically it is but it actually works differently to traditional chemo-clear as mud for the average reader! Agree with PaulaS, it comes down to audience.

[Psmithuk in reply to AussieNeil]

Thanks, Neil, interesting explanation. I have been wondering this myself!

Chris

[flowerchild28 in reply to AussieNeil]

I'm very grateful for your response. Thank God for modern medicine. Be well

[PaulaS Volunteer]

The distinction between chemo and non-chemo seems to depend on who we talk to. Many people, including medics, don't seem to make a distinction.

If a treatment is anticancer it's considered to be cytotoxic and therefore commonly called "chemotherapy" or "chemo" for short. Most people understand the words "chemo", they don't understand "targetted therapy" or "immunotherapy".

When I talk to most people about my being on Ibrutinib, I describe it as a new, less toxic form of chemotherapy. They understand that.

This morning I phoned my CLL specialist nurse about the delay in getting my repeat Ibrutinib prescription. She apologised that it hadn't gone through as planned, and said she'd sort it out for me.

She added that "We get people's chemotherapy drugs delivered to their homes these days so they can stay out of hospitals and chemist shops". I was very grateful and wasn't going to argue that Ibrutinib isn't really chemotherapy.

Paula

[ornstin]

Interesting question. According to the American Cancer Society website any drug used to treat any illness is Chemotherapy. So, on this basis, Gazyva would be a type of Chemotherapy, albeit a non-traditional type.

[BeckyLUSA]

It appears chemotherapy has multiple meanings, but in just looking at the word....Chemo - chemical? So would chemotherapy literally be translated as treatment using chemicals? Aren’t most all drugs chemicals? I know it came into usage as a cancer treatment only.

I tell my friends that Ibrutinib is “chemo lite”. Even though it targets the cells we want it to kill, it still effects many other innocent bystanders!

BeckyL USA

[Big_Dee]

Hello flowerchild28

Definition of chemotherapy " the treatment of disease by the use of chemical substances, especially the treatment of cancer by cytotoxic and other drugs". All drugs taken are technically chemotherapy or "chemo", but the Gazyva which is a monoclonal antibody sounds better and not so scary. Brutimustine is classed as "chemo" because it is toxic to many cells, (fastest growing), whereas monoclonal antibodies helps body suppress identical cancer cells. Whew that was a mouth full, hope this question is on my "home doctoring license exam).

[JustAGuy]

What people (including us) think of when they hear the word chemotherapy is like using a bomb to eradicate rats from a building. Targeted drugs like Obinituzimab (Gazvya), ibrutinib, Venetaclax, acalabrutinib, are like hiring a sharpshooter to kill the rats.

If insurance covers it because they call it chemotherapy, fine. But we know that there is a big difference...

[NaturalWaze]

My CLL specialist, Dr Lamanna, calls all these drugs chemotherapy. I have asked her about it, and gotten answers mentioned above. I like to “correct” her because I’m starting treatment with gazyva and hate the way chemo sounds! 😊