https://doi.org/10.4081/hmr.v1i5.641

Where does 90Y-ibritumomab tiuxetan radioimmunotherapy fit? Selecting the right patient

Vol. 1 No. 5: Changing the paradigm: new perspectives in the treatment of haematological malignancies
Published: June 17, 2009
Abstract Views: 217
PDF: 419
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Martin Bentz
support@pagepress.org
Radioimmunotherapy (RIT) with targeted monoclonal antibodies that emit ionising radiation is an effective treatment modality for B-cell non-Hodgkin’s lymphoma (NHL). RIT is designed to elicit anti-tumour effects through immunological and radiolytic mechanisms of action, and B-cell lymphomas are particularly ideal targets as they are inherently sensitive to radiation and express cell-surface antigens suitable for targeting. Yttrium-90 (90Y)-ibritumomab tiuxetan (Zevalin®), an anti-CD20 murine monoclonal antibody linked to the radionuclide 90Y, is the only form of RIT commercially available in Europe. 90Y-ibritumomab tiuxetan is licensed by the European Medicines Agency for therapy of adult patients with rituximab-relapsed or refractory CD20+ follicular B-cell NHL. Treatment with 90Y-ibritumomab tiuxetan comprises a short-course regimen that involves only a single dose of radioactive antibody. In a randomised phase III trial in rituximab-naïve patients with relapsed or refractory low-grade follicular or transformed CD20+ NHL, the overall response rate to 90Y-ibritumomab tiuxetan therapy was 80%, compared with 56% in patients treated with rituximab. 90Y-ibritumomab tiuxetan has also demonstrated efficacy in patients with multiple prior therapies and bulky tumours, along with elderly patients. The use of 90Y-ibritumomab tiuxetan is restricted to patients with <25% bone marrow infiltration by lymphoma cells, with reversible myelosuppression, manifesting clinically as cytopenias, as the dose-limiting toxicity. Because 90Y is a pure b-emitter with a short half-life, clinical therapy with 90Y-ibritumomab tiuxetan can be administered in an outpatient setting and patients released immediately afterwards unlike gamma radiation forms of RIT. Despite the nominal price of 90Y-ibritumomab tiuxetan, a single dose comprises an entire course of treatment and, as a third-line therapy, offers favourable cost-effectiveness when compared with that of rituximab.

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Bentz, M. (2009). Where does 90Y-ibritumomab tiuxetan radioimmunotherapy fit? Selecting the right patient. Hematology Meeting Reports (formerly Haematologica Reports), 1(5). https://doi.org/10.4081/hmr.v1i5.641
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