Unbound MEDLINE

Radioimmunotherapy for B-cell non-hodgkin lymphomas.

Abstract

BACKGROUND
Radioimmunotherapy (RIT) is a safe and effective therapeutic option for patients with indolent B-cell non-Hodgkin lymphomas (NHL), in both up-front and relapsed/refractory settings. Two approved agents (90Y-ibritumomab tiuxetan and 131I-tositumomab) are available in the United States. Both target CD20 with similar clinical outcomes but with unique clinical considerations and radiation precautions due to the use of varying radioisotopes.
METHODS
This paper reviews the available evidence for these approved RIT agents and examines the recently published and ongoing clinical trials of potential novel indications for aggressive B-cell NHL.
RESULTS
A pretreatment biodistribution evaluation required before administering the 90Y-ibritumomab tiuxetan therapeutic dose has been removed, which once limited its usage. The potential clinical applications of RIT include relapsed/refractory indolent B-cell NHL, diffuse large B-cell lymphoma, indolent lymphoma in the front-line setting, and mantle cell lymphoma. Multiple novel RIT agents are in preclinical and clinical development, and the addition of radiosensitizers or external-beam radiotherapy may act in synergy with RIT for both indolent and aggressive lymphomas. The risk of treatment-related myelodysplastic syndrome does not appear to be higher in patients treated with RIT over those receiving chemotherapy alone.
CONCLUSIONS
RIT is a safe, effective, and significantly underutilized therapy for patients with B-cell NHL, and many studies have demonstrated the efficacy of 90Y-ibritumomab tiuxetan and 131I-tositumomab for relapsed/refractory indolent B-cell lymphomas. Continued research to establish its efficacy for other lymphoma subtypes is warranted.

Links

  • Publisher Full Text

    • Authors

    Tomblyn M

    Institution

    Department of Radiation Oncology, Moffitt Cancer Center, Tampa, FL 33612, USA. Michael.Tomblyn@moffitt.org

    Source

    Cancer control : journal of the Moffitt Cancer Center 19:3 2012 Jul pg 196-203

    MeSH

    Antibodies, Monoclonal
    Humans
    Iodine Radioisotopes
    Lymphoma, B-Cell
    Radioimmunotherapy
    Radiopharmaceuticals
    Yttrium Radioisotopes

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't
    Review

    Language

    eng

    PubMed ID

    22710895