Update:Systemic Radiotherapy Can Cure Lymphoma: A Paradigm for Other Malignancies?

Abstract

The cytocidal potency of a molecule can be augmented by conjugating a radionuclide for molecular targeted radionuclide therapy (MTRT) for cancer. Radioimmunotherapy (RIT) should be incorporated into the management of patients with B-cell non-Hodgkin's lymphoma (NHL) soon after the patients have proven incurable. Better drugs, strategies, and combinations with other drugs seem certain to make RIT integral to the management of patients with NHL and likely to lead to a cure of the currently incurable NHL. These improved drugs, strategies, and combinations thereof also offer opportunities for RIT to become part of the management of solid malignancies, including epithelial cancers. Smaller radionuclide carriers, such as those used for pretargeted strategies, provide dose intensification. The potential of pretargeted RIT to improve patient outcomes is striking.

Les anticorps radiomarqués pour le traitement des cancers

“…Si le lymphome folliculaire est une maladie d'évolution lente, il reste encore pratiquement toujours fatal dans sa forme disséminée. Alors qu'aucun progrès thérapeutique n'avait été réalisé entre 1960 et 1996 [5], aujourd'hui le traitement par rituximab (anticorps anti-CD20) combiné à la chimiothérapie induit des taux de réponse de 70 à 100 %, sans toutefois obtenir de guérison (les réponses durent de 18 à 50 mois) [6] I-tositumomab est très efficace, au prix d'une greffe de cellules souches hémato-poïétiques (moelle osseuse) autologues et des risques associés [7]. L'association de Zévalin à la chimiothérapie intensive avant autogreffe est potentiellement plus efficace que la RIT à dose conventionnelle, mais nécessite une dosimétrie précise pour éviter les effets toxiques, notamment lors de l'administration de Zévalin à haute activité [8].…”

Pretherapy Prediction of Nephrotoxicity After Peptide Radionuclide Receptor Therapy (PRRT)

“…13 The current dialogue is evidence for the power of these methods and their progression in recent years. Dialogue among the experts is now related to preferred models rather than the usefulness and practicality of the methods.…”

Phase II Trial of Anticarcinoembryonic Antigen Pretargeted Radioimmunotherapy in Progressive Metastatic Medullary Thyroid Carcinoma: Biomarker Response and Survival Improvement

“…Pretargeted radioimmunotherapy (pRAIT) was developed to improve the therapeutic index (tumor-to-normaltissue ratios) and to deliver increased tumor-absorbed doses to solid tumors, which are more radioresistant than indolent lymphomas (11,12). pRAIT consists of first administering a bispecific monoclonal antibody (BsmAb), followed a few days later by a radiolabeled bivalent hapten (12).…”