Safety and Efficacy of Radioimmunotherapy with 90Yttrium-rituximab in Patients with Relapsed CD20+ B cell Lymphoma: A Feasibility StudyM Vaes1*, D Bron1, DJ Vugts2, M Paesmans3, N Meuleman1, G Ghanem4, T Guiot5, B Vanderlinden6, K Thielemans7, GAMS van Dongen8, P Flamen5 and K Muylle9
9Department of Nuclear Medicine, Institute Jules Bordet, Université Libre de Bruxelles, Bld de Waterloo 121, 1000 Brussels, Belgium and Faculty of Medicine, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
- *Corresponding Author:
- Mélanie Vaes
Department of Clinical Hematology
Institute Jules Bordet
Université Libre de Bruxelles
Bld de Waterloo 121
1000 Brussels, Belgium
Tel:+32 2 541 37 28
Fax: + 325440257
E-mail: [email protected]
Received date: October 08, 2012; Accepted date: November 12, 2012; Published date: November 14, 2012
Citation: Vaes M, Bron D, Vugts DJ, Paesmans M, Meuleman N, et al. (2012) Safety and Efficacy of Radioimmunotherapy with 90Yttrium-rituximab in Patients with Relapsed CD20+ B cell Lymphoma: A Feasibility Study. J Cancer Sci Ther 4: 394-400. doi:10.4172/1948-5956.1000173
Copyright: © 2012 Vaes M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Purpose: Both anti-CD20 antibodies (ibritumomab; ZEVALIN® and tositumomab; BEXXAR®) currently used for radioimmunotherapy of B cell non-Hodgkin’s lymphoma are murine immunoglobulins. The aim of this feasibility study was to evaluate the safety and efficacy of radioimmunotherapy with a human chimeric anti-CD20 antibody labelled with Yttrium-90 (90Y-rituximab) in patients with B cell lymphoma.
Methods: Patients with CD20+ B-cell lymphoma in partial remission or with progressive disease after at least one line of therapy were included. 90Y-rituximab was administered according to a similar schedule as currently approved by the European Medicines Agency for the treatment with 90Y-ibritumomab tiuxetan (ZEVALIN®): a first infusion of rituximab 250 mg/m² is repeated one week later and directly followed by the injection of 90Y-rituximab (14,8 MBq/kg). 18FDG-PET/CT was performed before treatment and repeated 3 months after for response assessment.
Results: Twenty-six patients were treated with 90Y-rituximab. Disease histologies included mainly follicular lymphomas (53%). Toxicity was primarily haematological. The incidence of grade 3-4 neutropenia, thrombocytopenia and anemia were 34%, 38%, and 8% respectively, with spontaneous recovery in all but one patient that needed autologous stem cell transplant for refractory thrombocytopenia. Among the relevant long-term side effects, one patient developed secondary myelodysplasia 2 years after the treatment. The overall response rate was 88% (95% CI: 70%-98%), including 65% complete metabolic responses and 23% partial metabolic responses. After a median follow-up of 29.6 months, the Kaplan-Meier estimated median progression-free survival was 9, 1 months (95% CI 6,1-17,9). Median time to next treatment was 24 months (95% CI: 12, 2-28).
Conclusion: Radioimmunotherapy with 90Y-rituximab in patients with relapsed CD20+ B-cell lymphomas is safe, well tolerated and effective when the ZEVALIN® treatment schedule is used.