Radioimmunotherapy Confers Long-Term Survival to Lymphoma Patients with Acceptable Toxicity: Registry Analysis by the International Radioimmunotherapy Network

Hohloch, Karin; Delaloye, Angelika Bischof; Windemuth-Kieselbach, C.; Gómez-Codina, José; Linkesch, Werner; Jurczak, Wojciech; Cacchione, Roberto; Suh, Cheolwon; Zinzani, Pier Luigi; Trümper, Lorenz

doi:10.2967/jnumed.111.089920

Cited by 18 publications

(10 citation statements)

References 17 publications

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“…Nadir occurred 7–9 weeks after Zevalin ® injection, and 4–6 weeks after Bexxar ® injection. In the long-term analysis of the international RIT-N, no significant difference was observed between patients with FL and patients with other lymphoma histologies (23). Time to complete recovery of blood count (hemoglobin > 12 g/dL, platelets > 150,000/μL, and leukocytes > 4,300/μL) had a median of 99 days for FL patients and 97 days for patients with other lymphoma subtypes.…”

Section: Rit Of Nhl In Clinical Practicementioning

confidence: 90%

“…In 2011 The International Radioimmunotherapy Network (RIT-N) reported on the long-term observational data from 467 Zevalin ® -treated patients with an observation time of at least 12 months outside the randomized clinical studies (23). Lymphoma subtype was documented for all patients at initial diagnosis: 58% FL, 20% DLBCL, 14% MCL, and less than 10% other subtypes.…”

Section: Rit Of Nhl In Clinical Practicementioning

confidence: 99%

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Radioimmunotherapy of B-cell non-Hodgkin’s lymphoma

et al. 2013

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This manuscript reviews current advances in the use of radioimmunotherapy (RIT) for the treatment of B-cell non-Hodgkin’s lymphoma (NHL). RIT has been in use for more than 20 years and has progressed significantly with the discovery of new molecular targets, the development of new stable chelates, the humanization of monoclonal antibodies (MAbs), and the use of pretargeting techniques. Today, two products targeting the CD20 antigen are approved: 131I-tositumomab (Bexxar®), and 90Y-ibritumomab tiuxetan (Zevalin®). 131I-tositumomab is available in the United States, and 90Y-ibritumumab tiuxetan in Europe, the United States, Asia, and Africa. RIT can be integrated in clinical practice using non-ablative activities for treatment of patients with relapsed or refractory follicular lymphoma (FL) or as consolidation after induction chemotherapy in front-line treatment in FL patients. Despite the lack of phase III studies to clearly define the efficacy of RIT in the management of B lymphoma in the era of rituximab-based therapy, RIT efficacy in NHL has been demonstrated. In relapsing refractory FL and transformed NHL, RIT as a monotherapy induces around 30% complete response with a possibility of durable remissions. RIT consolidation after induction therapy significantly improves the quality of the response. Dose-limiting toxicity of RIT is hematological, depending on bone marrow involvement and prior treatment. Non-hematological toxicity is generally low. Different studies have been published assessing innovative protocols of RIT or new indications, in particular treatment in patients with aggressive lymphomas. High-dose treatment, RIT as consolidation after different therapeutic induction modalities, RIT in first-line treatment or fractionated RIT showed promising results. New MAbs, in particular humanized MAbs, or combinations of naked and radiolabeled MAbs, also appear promising. Personalized dosimetry protocols should be developed to determine injected activity.

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Section: Rit Of Nhl In Clinical Practicementioning

confidence: 90%

Section: Rit Of Nhl In Clinical Practicementioning

confidence: 99%

Radioimmunotherapy of B-cell non-Hodgkin’s lymphoma

et al. 2013

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“…11 Hematologic toxicity is the major side effect of RIT and depends on bone marrow involvement and prior treatment. 12,13 Nonhematologic toxicity is generally low. Secondary myelodysplastic syndrome (MDS) or acute myelogenous leukemia (AML) was reported in 1%-3% of cases.…”

Section: High Efficacy Of Rit In Nhblmentioning

confidence: 99%

Radioimmunoconjugates for the Treatment of Cancer

Kraeber-Bodéré

Bodet-Milin

Rousseau

et al. 2014

Seminars in Oncology

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“…The radionuclide 90 Y, a pure β-emitter, deposits 90% of its energy within 5 mm of the point of disintegration and binds tightly to tiuxetan. A number of clinical studies have demonstrated the clinical efficacy of 90 Y-IT in non-Hodgkin's lymphomas [10,12,13,14,15,16]. Treatment-related toxicity with 90 Y-IT is mild compared with standard salvage regimens.…”

Section: Introductionmentioning

confidence: 99%

Yttrium-90 Ibritumomab Tiuxetan Followed by Rituximab Maintenance as Treatment for Patients with Diffuse Large B-Cell Lymphoma Are Not Candidates for Autologous Stem Cell Transplant

et al. 2015

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Background: Not all patients with diffuse large B-cell lymphoma (DLBCL) are candidates for aggressive regimens. ⁹⁰Y ibritumomab tiuxetan (⁹⁰Y-IT), an anti-CD20 radionuclide-conjugated antibody, has demonstrated clinical efficacy in DLBCL with a favorable toxicity profile. Methods: This phase II trial investigated the overall response rate (ORR), event-free survival (EFS), overall survival (OS) and toxicity of treatment with ⁹⁰Y-IT (0.4 or 0.3 mCi ⁹⁰Y/kg based on platelets) followed by rituximab maintenance therapy in patients with DLBCL not candidates for transplant. Results: 25 patients were enrolled. At best response 8 patients obtained a complete response (CR) and 1 a partial response (ORR 36%). Median EFS was 2.5 months and OS 8.1 months. No patient who obtained CR later relapsed systemically. Two patients were free of disease at the 61- and 100-month follow-ups; 65% had grade 3/4 thrombocytopenia, but no significant bleeding was observed. Grade 3 nonhematologic toxicity occurred in 36%. Patients who had progressed through a rituximab-containing regimen responded poorly. Conclusion: The ORR of 36% with ⁹⁰Y-IT as salvage therapy for DLBCL while inferior to more aggressive regimens is significant with acceptable toxicity. For a subset of patients not candidates for salvage with autologous transplant, this treatment strategy can produce a durable, long-lasting remission.

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Radioimmunotherapy Confers Long-Term Survival to Lymphoma Patients with Acceptable Toxicity: Registry Analysis by the International Radioimmunotherapy Network

Cited by 18 publications

References 17 publications

Radioimmunotherapy of B-cell non-Hodgkin’s lymphoma

Radioimmunotherapy of B-cell non-Hodgkin’s lymphoma

Radioimmunoconjugates for the Treatment of Cancer

Yttrium-90 Ibritumomab Tiuxetan Followed by Rituximab Maintenance as Treatment for Patients with Diffuse Large B-Cell Lymphoma Are Not Candidates for Autologous Stem Cell Transplant

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