Consensus conference: Implementing treatment recommendations on yttrium-90 immunotherapy in clinical practice – Report of a European workshop

Zinzani, Pier Luigi; d’Amore, Francesco; Bombardieri, Emilio; Brammer, Caroline; Codina, José; Illidge, Tim; Jurczak, Wojciech; Linkesch, Werner; Morschhauser, Franck; Vandenberghe, Elisabeth; Hoof, A. van

doi:10.1016/j.ejca.2007.12.008

Cited by 23 publications

(13 citation statements)

References 44 publications

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“…In the European Union, 90 Y-ibritumomab tiuxetan is also indicated as consolidation therapy after remission induction in previously untreated patients with FL (7), whereas 131 I-tositumomab is not registered in Europe. As for chemotherapy, response rates after radioimmunotherapy tend to be higher and response durations tend to be longer when radioimmunotherapy is given during the early stage of the disease rather than after numerous earlier treatment courses (4,8). Excellent results have been obtained with 131 I-tositumomab given as first-line therapy in FL (9).…”

Section: Fol Licular Lymphoma (Fl) Is the Most Common Form Of Indolenmentioning

confidence: 60%

“…Recently, an expert panel of oncologists, hematologists, and nuclear medicine physicians recommended the incorporation of radioimmunotherapy into national lymphoma treatment algorithms across Europe (4). Currently, the murine anti-CD20 monoclonal antibodies 90 Yibritumomab tiuxetan (Zevalin; Bayer Schering Pharma AG) and 131 I-tositumomab (Bexxar; GlaxoSmithKline) are registered in the United States for the treatment of relapsed or refractory low-grade or follicular NHL (5,6).…”

Section: Fol Licular Lymphoma (Fl) Is the Most Common Form Of Indolenmentioning

confidence: 99%

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Dosimetry of ⁹⁰Y-Ibritumomab Tiuxetan as Consolidation of First Remission in Advanced-Stage Follicular Lymphoma: Results from the International Phase 3 First-Line Indolent Trial

Delaloye¹,

Antonescu²,

Louton³

et al. 2009

J Nucl Med

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The objective of this analysis was to assess the radiation exposure associated with 90 Y-ibritumomab tiuxetan when used as consolidation therapy in adults with low or minimal tumor burden after first-line therapy of advanced follicular lymphoma (FL). Methods:The patients who were enrolled in the phase 3 firstline indolent trial were 18 y or older, with CD20 1 grade 1 or 2 stage III or IV FL, and a partial response, complete response, or unconfirmed complete response to first-line chemotherapy. The patients were allocated randomly to receive a single infusion of unlabeled rituximab 250 mg/m 2 on day 27 and consolidation on day 0 with a single dose of 90 Y-ibritumomab tiuxetan, 14.8 MBq/kg, immediately after unlabeled rituximab, 250 mg/m 2 , or no further treatment. On day 27, a subset of patients received an injection of 185 MBq of 111 In-ibritumomab tiuxetan immediately after unlabeled rituximab, 250 mg/m 2 , for central dosimetry analysis. Correlations were assessed between organ radiation absorbed dose and toxicity, body weight, body mass index, and progression-free survival. Results: Central dosimetry evaluations were available from 57 of 70 patients. Median radiation absorbed doses were 100 cGy (range, 28-327 cGy) for the red marrow and 72 cGy (range, 46-106 cGy) for the whole body. Radiation absorbed doses did not differ significantly between patients who had a partial response or complete response to initial therapy. Progression-free survival correlated significantly with the whole-body (r 5 0.4401; P 5 0.0006) and bone marrow (r 5 0.2976; P 5 0.0246) radiation dose. Body weight was significantly negatively correlated with whole-body radiation dose (r 5 20.4971; P , 0.0001). Neither the whole-body radiation dose nor the bone marrow radiation dose correlated with hematologic toxicity. Conclusion: In patients with low or minimal residual tumor burden after first-line chemotherapy of advanced FL, wholebody and bone marrow exposure after 90 Y-ibritumomab tiuxetan consolidation showed a significant positive correlation with progression-free survival, whereas dosimetric data could not predict hematologic toxicity.

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Section: Fol Licular Lymphoma (Fl) Is the Most Common Form Of Indolenmentioning

confidence: 60%

Section: Fol Licular Lymphoma (Fl) Is the Most Common Form Of Indolenmentioning

confidence: 99%

Dosimetry of ⁹⁰Y-Ibritumomab Tiuxetan as Consolidation of First Remission in Advanced-Stage Follicular Lymphoma: Results from the International Phase 3 First-Line Indolent Trial

Delaloye¹,

Antonescu²,

Louton³

et al. 2009

J Nucl Med

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“…To have maximum benefit to a disease population, therapy needs to be accessible "off study," but used in the context of consensus clinical guidelines. 18 In a single-center study comparing experience with 90 Yibritumomab tiuxetan and 131 I-tositumomab in routine clinical practice outside the context of clinical trials, RIT was well tolerated, but the response rates were at the low end of those reported in the clinical trial literature with objective response rates (ORRs) of 47% and complete response (CR) of 13%. 19 Toxicity was relatively high, with grade 3/4 neutropenia (55%) and thrombocytopenia (56%).…”

Section: Introductionmentioning

confidence: 99%

“…12,13,28 In the recommendations of a recent European Consensus Guidelines workshop (Windsor, United Kingdom), RIT was incorporated as an effective treatment of NHL. 18 In particular, use of RIT early in the course of follicular lymphoma was recommended to optimize patient outcomes. 18 In clinical practice, however, RIT frequently remains a treatment of last resort, when it is least likely to be effective.…”

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confidence: 99%

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Radioimmunotherapy of relapsed indolent non-Hodgkin lymphoma with 131I-rituximab in routine clinical practice: 10-year single-institution experience of 142 consecutive patients

Leahy¹,

Turner

2011

Blood

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Consensus conference on the use of 90‐yttrium‐ibritumomab tiuxetan therapy in clinical practice. A project of the Italian Society of Hematology

et al. 2010

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90-Yttrium-ibritumomab-tiuxetan is approved for treatment of rituximab-relapsed/refractory CD20+ follicular B-cell lymphoma and as consolidation therapy in untreated follicular lymphoma. Recommendations on the use of 90-yttrium-ibritumomab tiuxetan were issued in a consensus conference, sponsored by the Italian Society of Hematology and the Italian Association of Nuclear Medicine. Current concepts and scientific evidence on the use of 90-yttrium-ibritumomab-tiuxetan were evaluated by a panel of seven experts. The following key recommendations were issued. The most important exclusion criteria are: bone marrow infiltration by lymphoma cells and platelet count or neutrophil count lower than 100 × 109/L or 1.5 × 10 9/L. The most relevant indication for 90Y-ibritumomab- tiuxetan is as a single agent or following debulking chemotherapy for relapsed/refractory follicular lymphoma. 90Y-ibritumomab tiuxetan as a single agent is effective in improving the quality and duration of the response in follicular lymphoma after primary chemotherapy or immunochemotherapy. 90Y-ibritumomab-tiuxetan as a single agent has activity in relapsed/refractory mantle cell lymphoma and DLBCL, but the responses are of short duration. Its use after first line chemoimmunotherapy as consolidation therapy appears promising, particularly in elderly patients. The addition of 90Y-ibritumomab-tiuxetan to high-dose chemotherapy, such as BEAM, is feasible and may be recommended for patients with high-risk relapsed/refractory lymphoma. Subsequent lines of therapy can be successfully used in patients who relapse after radioimmunotherapy. © 2009 Wiley-Liss, Inc

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Consensus conference: Implementing treatment recommendations on yttrium-90 immunotherapy in clinical practice – Report of a European workshop

Cited by 23 publications

References 44 publications

Dosimetry of ⁹⁰Y-Ibritumomab Tiuxetan as Consolidation of First Remission in Advanced-Stage Follicular Lymphoma: Results from the International Phase 3 First-Line Indolent Trial

Dosimetry of ⁹⁰Y-Ibritumomab Tiuxetan as Consolidation of First Remission in Advanced-Stage Follicular Lymphoma: Results from the International Phase 3 First-Line Indolent Trial

Radioimmunotherapy of relapsed indolent non-Hodgkin lymphoma with 131I-rituximab in routine clinical practice: 10-year single-institution experience of 142 consecutive patients

Consensus conference on the use of 90‐yttrium‐ibritumomab tiuxetan therapy in clinical practice. A project of the Italian Society of Hematology

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Consensus conference: Implementing treatment recommendations on yttrium-90 immunotherapy in clinical practice – Report of a European workshop

Cited by 23 publications

References 44 publications

Dosimetry of 90Y-Ibritumomab Tiuxetan as Consolidation of First Remission in Advanced-Stage Follicular Lymphoma: Results from the International Phase 3 First-Line Indolent Trial

Dosimetry of 90Y-Ibritumomab Tiuxetan as Consolidation of First Remission in Advanced-Stage Follicular Lymphoma: Results from the International Phase 3 First-Line Indolent Trial

Radioimmunotherapy of relapsed indolent non-Hodgkin lymphoma with 131I-rituximab in routine clinical practice: 10-year single-institution experience of 142 consecutive patients

Consensus conference on the use of 90‐yttrium‐ibritumomab tiuxetan therapy in clinical practice. A project of the Italian Society of Hematology

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Dosimetry of ⁹⁰Y-Ibritumomab Tiuxetan as Consolidation of First Remission in Advanced-Stage Follicular Lymphoma: Results from the International Phase 3 First-Line Indolent Trial

Dosimetry of ⁹⁰Y-Ibritumomab Tiuxetan as Consolidation of First Remission in Advanced-Stage Follicular Lymphoma: Results from the International Phase 3 First-Line Indolent Trial