90Y-ibritumomab Tiuxetan Safe And Effective For Non-Hodgkin's Lymphoma Patients After Chemotherapy

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90Y-ibritumomab Tiuxetan Safe And Effective For Non-Hodgkin's Lymphoma Patients

After Chemotherapy

25 Apr 2008

Radioimmunotherapy using the radioactive drug yttrium-90 (90Y) ibritumomab

tiuxetan following chemotherapy with fludarabine and mitoxantrone is feasible,

well tolerated, and effective for follicular non-Hodgkin's lymphoma (NHL)

patients. This was published on March 13, 2008 in The Lancet Oncology.

Follicular lymphoma is cancer of the lymphocytes of the follicle center

B-lymphocytes. Approximately 30% of all newly diagnosed NHLs are follicular

lymphomas, making it the most common type of lymphoma in the United States and

Europe. Various trials have previously shown that the combination of a

chemotherapy regiment with rituximab, a targeted B-cell lymphoma treatment that

is not radioactive, will increase the instance of progression-free survival in

comparison with the chemotherapy regimen alone. Similar to rituximab,

90Y-ibritumomab tiuxetan is a drug which is able to target B-cell lymphomas by

attaching to specific surface proteins on the cells. However, once attached, the

radioactive yttrium-90 attacks and kills the highly sensitive lymphoma cells as

it emits ?-radiation.

To discover the potential benefits of 90Y-ibritumombab tiuxetan over rituximab,

Professor Pier Luigi Zinzani, Institute of Haematology and Oncology " L & A

Seragnoli " , University of Bologna, Italy, and colleagues studied 61 patients in

13 different institutions in Italy. All patients were administered six cycles of

oral fludarabine and intraveouns mitoxantrone. 57 of these were deemed eligible

for subsequent treatment with 90Y-ibritumomab tiuxetan, 43 of these with a

complete response (CR) to the therapy and 14 with partial responses (PR).

12 of the 14 PRs reached complete response in the latter part of the trial after

the combined treatment regimen. With a followup of 30 months median, the three

year progression free survival was estimated at 76%, with a three year overall

survival of 100%. 36 of the 57 total patients showed grade 3 or 4 haemotological

toxic effects.

The authors indicate that this study shows promise for combination therapies

using 90Y-ibritumomab tiuxetan. They conclude: " This study has established the

feasibility, tolerability, and efficacy of sequential treatment with six cycles

of fludarabine and mitoxantrone chemotherapy followed by 90Y-ibritumombab

tiuxetan as a front-line treatment for untreated patients with follicular NHL.

In particular, the data represent the first evidence of a role of

90Y-ibritumombab tiuxetan after a fludarabine-containing regimen in the

treatment of follicular NHL. "

Fludarabine and mitoxantrone followed by yttrium-90 ibritumomab tiuxetan in

previously untreated patients with follicular non-Hodgkin lymphoma trial: a

phase II non-randomised trial (FLUMIZ)

Pier Luigi Zinzani, Tani, Alessandro Pulsoni, Marco Gobbi, Alessio

Perotti, Stefano De Luca, Alberto Fabbri, Alfonso Zaccaria, Voso,

Pierpaolo Fattori, Luciano Guardigni, Ronconi, Giuseppina Cabras,

Luigi Rigacci, Amalia De Renzo, Enrica Marchi, Vittorio Stefoni, paola

Fina, Cinzia Pellegrini, Gerardo Musuraca, Enrico Derenzini, Stefano Pileri,

Stefano Fanti, Pier Paolo Piccaluga, Michele Baccarani

The Lancet Online March 13, 2008

DOI:10.1016/S1470-2045(08)70039-1