Bexxar: novel radioimmunotherapy for the treatment of low-grade and transformed low-grade non-Hodgkin's lymphoma.

Abstract

PURPOSE:

Immunotherapy using monoclonal antibodies to specifically target B cells has provided new hope to many patients with indolent lymphomas, particularly those with chemotherapy-refractory disease. Lymphomas are extremely sensitive to radiation, and significant progress has been made over the last decade in the development of radioimmunotherapy with anti-CD20 antibodies.

MATERIALS AND METHODS:

Herein we review clinical experience with tositumomab and iodine I 131 tositumomab (Bexxar; Corixa Corporation; South San Francisco, CA; and GlaxoSmithKline; Philadelphia, PA) in patients with non-Hodgkin's lymphoma.

RESULTS:

Therapy with Bexxar has demonstrated high response rates and long durations of response compared with unconjugated anti-CD20 antibodies in patients with relapsed low-grade and transformed low-grade non-Hodgkin's lymphomas. Iodine-131 (I-131) has a long history of clinical experience, an excellent safety record, and favorable nuclear and pharmacologic properties. Importantly, the gamma emissions of iodine-131 facilitate accurate dosimetry to calculate the appropriate patient-specific therapeutic activity to deliver a predetermined total-body dose of radiation, thereby minimizing hematologic toxicity. In clinical trials of Bexxar, objective response rates ranged from 54%-71% in heavily pretreated patients. In the pivotal trial, the number of patients with a longer duration of response after treatment with Bexxar was significantly greater than the number of patients with a longer duration of response after their last qualifying chemotherapy regimen. In 76 newly diagnosed patients, the objective response rate was 97%, and 63% of patients achieved complete responses.

CONCLUSION:

These data suggest that Bexxar will become an important new option in the treatment of indolent lymphoma.

• Authors: Julie M Vose
• Journal: The oncologist (Oncologist) Vol. 9 Issue 2 Pg. 160-72 ( 2004) ISSN: 1083-7159 [Print] England
• PMID: 15047920 (Publication Type: Journal Article, Review)

Chemical References

• Antibodies, Monoclonal
• Antineoplastic Agents
• tositumomab I-131

Topics

• Antibodies, Monoclonal (therapeutic use)
• Antineoplastic Agents (therapeutic use)
• Clinical Trials as Topic
• Dose-Response Relationship, Radiation
• Humans
• Lymphoma, Non-Hodgkin (radiotherapy)
• Radioimmunotherapy (methods)
• Treatment Outcome