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.

• Authors: Michael Tomblyn
• Journal: Cancer control : journal of the Moffitt Cancer Center (Cancer Control) Vol. 19 Issue 3 Pg. 196-203 (Jul 2012) ISSN: 1526-2359 [Electronic] United States
• PMID: 22710895 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)

Chemical References

• Antibodies, Monoclonal
• Iodine Radioisotopes
• Radiopharmaceuticals
• Yttrium Radioisotopes
• ibritumomab tiuxetan
• tositumomab I-131

Topics

• Antibodies, Monoclonal (therapeutic use)
• Humans
• Iodine Radioisotopes (therapeutic use)
• Lymphoma, B-Cell (radiotherapy)
• Radioimmunotherapy (adverse effects, methods)
• Radiopharmaceuticals (therapeutic use)
• Yttrium Radioisotopes (therapeutic use)