Long-term efficacy of 90Y ibritumomab tiuxetan therapy in follicular non-Hodgkin lymphoma and health-related quality of life

Abstract

The aim of this study was to analyze the outcomes of 37 follicular lymphoma (FL) patients treated with (90)ytrium ibritumomab tiuxetan (90Y-IT), outside of clinical trial, according to protocol ISCRTN36210045, after ≥5 years follow-up to February 2014. Health-related quality of life (HRQoL) was evaluated with the SF-36, Spanish version, and compared with the general population of Spain. Patients had a mean age of 61.9 (range, 30-85) years and included 18 males. FLIPI, low: 25 (67.6 %), intermedium 9 (24.3 %), and low 3 (8.1 %). Previous therapy schedules >2: 48.6 % The median follow-up was 66 months, mean Time to Relapse (TTR) 71.3 months (58.8-83.8) median not reached. Thirty-four patients achieved complete response (91.8 %), and three no response. Mean overall survival: 82.3 months (71.6-92.9). Four patients presented with concomitant tumors (colon, breast, prostate, lung) after radioimmunotherapy, and three developed second primary neoplasms (esophagus, renal, and myelodysplastic syndrome in a relapsed patient who received fludarabine). Four of 10 deaths were related to lymphoma progression. Hematological toxicities were mild and easily managed. No patients required hospitalization. Negative scores were obtained in the physical and emotional roles items; however, the perception of general health and vitality were better than in the general population, with the best outcomes in non-relapsed patients. Radioimmunotherapy with 90Y-IT was safe and effective as long-term therapy in patients with FL. Early use of radioimmunotherapy could offer good, sustained responses with low toxicity over the long term and acceptable HRQoL.

Long‐term complication in follicular lymphoma: assessing the risk of secondary neoplasm in 242 patients treated or not with 90‐yttrium‐ibritumomab‐tiuxetan

“…Radioimmunotherapy becomes available in our institution in September 2005 and it has been used under a multidisciplinary protocol previously described ISCRTN36210045 . For this work, ethical institutional board approves the development of this retrospective analysis according to the Helsinki declaration of 1975, modified October 2013.…”

“…The use of the combined regimen of rituximab, cyclophosphamide, hydroxydaunorubicin, vincristine, and prednisone (R‐CHOP) had been the most spread used schedule of therapy, but other schemes have been raising like rituximab–bendamustine and so on ; at the same time, consolidation and maintenance approaches like rituximab maintenance every 8 wk during 2 yr or consolidation with radioimmunotherapy (RIT) with 90‐yttrium‐ibritumomab‐tiuxetan (ZEVALIN ® ; Spectrum Pharmaceuticals. Henderson, NV) had decreased the rate of relapses improving the time free of therapy .…”

90Y-ibritumomab Tiuxetan in B-cell Non-Hodgkin Lymphomas: Real-world Data From the United Arab Emirates

“… 27 In refractory or relapsing FL cases, 90 YIT proved to be effective in the long term (≥5 years of follow-up; mean estimated OS, 82.3 months) with an acceptable health-related quality of life. 28 …”

Long‐term efficacy and safety of chemotherapy‐free first‐line iodine‐131‐rituximab radioimmunotherapy of follicular lymphoma

“…This is the first report of long‐term patient outcomes following first‐line 131 I‐RIT of FL. The results demonstrate sustained treatment‐free remissions with minimal long‐term toxicity and excellent survival outcomes, comparing favourably to first‐line yttrium‐90‐ibritumomab RIT of FL 9,14 . The current therapeutic landscape for FL is dominated by chemoimmunotherapy induction followed by antibody maintenance for up to two years.…”