Abstract |
The effect of induction therapy with multiple doses of rituximab on the subsequent efficacy and toxicity of anti-CD20 radioimmunotherapy is unknown. We evaluated a novel protocol using 4 weekly infusions of 375 mg/m(2) rituximab followed by 2 fractions of (131)I-rituximab, preceded by a 100-mg/m(2) predose of rituximab, in relapsed indolent B-cell lymphoma. Induction therapy with rituximab significantly increased the effective half-life of (131)I-rituximab (P = .003) and high serum levels of rituximab after induction therapy correlated with increased effective half-life of the radioimmunoconjugate (P = .009). Patients with large tumor burdens experienced significant increases in the effective half-life of (131)I-rituximab between delivery of the first and second fractions (P = .007). Induction therapy with multiple doses of rituximab did not appear to compromise the clinical efficacy or increase toxicity of subsequent (131)I-rituximab radioimmunotherapy. The overall response rate was 94%, with complete response rate 50%. The median time to progression was 20 months, significantly longer than for the last qualifying chemotherapy (P = .001). Fractionation of (131)I-rituximab allowed cumulative whole-body doses of more than 120 cGy, approximately 60% greater than those previously achieved with a single administration of a murine radioimmunconjugate, to be delivered without significant hematologic toxicity.
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Authors | Tim M Illidge, Mike Bayne, Nicholas S Brown, Samantha Chilton, Mark S Cragg, Martin J Glennie, Yong Du, Valerie Lewington, James Smart, James Thom, Maureen Zivanovic, Peter W M Johnson |
Journal | Blood
(Blood)
Vol. 113
Issue 7
Pg. 1412-21
(Feb 12 2009)
ISSN: 1528-0020 [Electronic] United States |
PMID | 19074729
(Publication Type: Clinical Trial, Phase I, Clinical Trial, Phase II, Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Antibodies, Monoclonal
- Antibodies, Monoclonal, Murine-Derived
- Hemoglobins
- Iodine Radioisotopes
- Rituximab
- 131I-rituximab
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Topics |
- Adult
- Aged
- Antibodies, Monoclonal
(administration & dosage, adverse effects, pharmacokinetics)
- Antibodies, Monoclonal, Murine-Derived
- Disease-Free Survival
- Dose-Response Relationship, Radiation
- Female
- Hemoglobins
- Humans
- Iodine Radioisotopes
(administration & dosage, adverse effects, pharmacokinetics)
- Lymph Nodes
(pathology)
- Lymphoma, B-Cell
(drug therapy, pathology, radiotherapy)
- Male
- Middle Aged
- Neutrophils
(cytology)
- Platelet Count
- Radioimmunotherapy
(methods)
- Rituximab
- Spleen
(pathology)
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