Efficacy and safety of yttrium-90 ibritumomab tiuxetan in patients with relapsed or refractory diffuse large B-cell lymphoma not appropriate for autologous stem-cell transplantation

Abstract

A prospective, multicenter, nonrandomized phase 2 trial was conducted to evaluate the efficacy and safety of a single dose of yttrium-90 ( 90 Y) ibritumomab tiuxetan in elderly patients in first relapsed or primary refractory diffuse large B-cell lymphoma (DLBCL) ineligible for stem-cell transplantation. Patients had been previously treated with chemotherapy (group A, n ‫؍‬ 76) or chemotherapy plus rituximab (group B, n ‫؍‬ 28). Patients in group A were further divided into patients in whom induction therapy had failed (stratum AI, n ‫؍‬ 33) and patients who had relapsed after achieving complete response (CR; stratum AII, n ‫؍‬ 43). The overall response rate (ORR) was 52% and 53% in strata AI and AII, respectively, and 19% in group B, with CR/CRu rates of 24%, 39.5%, and 12%, respectively. Median progressionfree survival was 5.9 months and 3.5 months in strata AI and AII, respectively, and 1.6 months in group B. Median overall survival was 21.4, 22.4, and 4.6 months in stratum AI, stratum AII, and group B, respectively. Two patients died from thrombocytopenic cerebral bleeding following administration of therapy. Nonhematologic adverse events were mild to moderate. 90 Y-ibritumomab is active in patients with relapsed and refractory diffuse large B-cell lymphoma (DLBCL) and its further evaluation in phase 3 studies is ongoing. (Blood. 2007;110:54-58)

Preclinical and clinical evaluation of epratuzumab (anti-CD22 IgG) in B-cell malignancies

“…Additional studies have moved radioimmunotherapy into first-line treatment with impressive results, and accumulating evidence suggests that subsequent treatments can be administered as necessary in the majority of patients (Ansell et al, 2002;Kaminski et al, 2005;Dosik et al, 2006). Single-agent results in more aggressive lymphoma subtypes have been more limited (Zelenetz and Vose, 2002;Fisher et al, 2004;Morschhauser et al, 2004;Cheson, 2005;Coiffier, 2005;, leading to the development of strategies employing sequential combinations of rituximab-CHOP followed by radioimmunotherapy (Morschhauser et al, 2004). Ongoing studies are evaluating the optimal setting for the incorporation of this important new modality into standard therapies.…”

Radioimmunotherapy with 131I-Rituximab in a Patient with Diffuse Large B-Cell Lymphoma Relapsed After Treatment with 90Y-Ibritumomab Tiuxetan

“…Morschhauser et al reported that 90 Y-ibritumomab tiuxetan used as a second-line therapy for patients with relapsed DLBCL who had previously been treated with R-CHOP as a first-line therapy contributed to an overall response rate of 23 % (3 of 13 patients) [7]. 90 Yibritumomab has also been evaluated as a post-remission therapy in high-risk patients [8] or elderly patients with DLBCL [9,10].…”

Radioimmunotherapy for Non-Hodgkin Lymphoma : Historical Perspective and Current Status

“…49 The activity of single agent 90 Y-IT in relapsed or refractory diffuse large B-cell NHL was confirmed in a multicenter prospective phase II European study. 50 An overall 44% response rate with 27% CR rate were observed. The results favored rituxan naive patients.…”