Yttrium 90 ibritumomab tiuxetan radioimmunotherapy for relapsed or refractory low-grade non-Hodgkin's lymphoma.
The treatment of malignant lymphoma has improved over the past 20 years, but the majority of patients are not cured. New modalities using targeted therapy based on new information in molecular biology and immunology hold promise for better outcomes with less toxicity. We review data on the use of radiolabeled monoclonal antibodies directed against the CD20 antigen on malignant B cells. We discuss the major radionuclides available, iodine 131 ((131)I), tositumomab, and yttrium 90 ((90)Y) ibritumomab tiuxetan (Zevalin; IDEC Pharmaceuticals, San Diego, CA) and present data on new approaches in labeling antibodies that have facilitated their use. Clinical trial data with the yttrium-labeled antibodies are discussed. The use of dosimetry as a means for predicting toxicity is discussed, and the questions of long-term toxicity (late effects) are addressed. These targeted approaches to the treatment of malignancy, and lymphoma in particular, hold great promise.
Gordon
Leo I
LI
Division of Hematology/Oncology, Department of Medicine, Northwestern University Medical School and the Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL 60611-2927, USA.
Witzig
Thomas E
TE
Wiseman
Greg A
GA
Flinn
Ian W
IW
Spies
Stewart S
SS
Silverman
Daniel H
DH
Emmanouilides
Christos
C
Cripe
Larry
L
Saleh
Mansoor
M
Czuczman
Myron S
MS
Olejnik
Teresa
T
White
Christine A
CA
Grillo-López
Antonio J
AJ
Emmanuolides
Christos
C
D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D018951:Antigens, CD20; D002986:Clinical Trials as Topic; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D016393:Lymphoma, B-Cell / Q000532:radiotherapy; D008228:Lymphoma, Non-Hodgkin / Q000532:radiotherapy*; D011788:Quality of Life; D016499:Radioimmunotherapy; D019275:Radiopharmaceuticals / Q000627:therapeutic use*; D011879:Radiotherapy Dosage; D015021:Yttrium Radioisotopes / Q000627:therapeutic use*
D000911:Antibodies, Monoclonal; D018951:Antigens, CD20; D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals; D015021:Yttrium Radioisotopes; C422802:ibritumomab tiuxetan; C119496:tositumomab I-131