Potential of chemo-immunotherapy and radioimmunotherapy in relapsed primary central nervous system (CNS) lymphoma

Nancy Doolittle, Kristoph Jahnke, Richard Belanger, Deborah A. Ryan, Robert Nance, Cynthia A. Lacy, Rose Marie Tyson, Marianne Haluska, Nancy A. Hedrick, Csanad Varallyay, Edward Neuwelt

Research output: Contribution to journalArticle

33 Scopus citations

Abstract

Five patients with relapsed PCNSL were given chemo-immunotherapy (rituximab followed by carboplatin and methotrexate) with osmotic blood-brain barrier (BBB) opening. Four patients achieved CR and one patient had stable disease. Two patients (2/5) had durable responses (survival: 230+, 122+, 82, 42, 38 weeks). One patient later received Indium-111-ibritumomab tiuxetan and Yttrium-90-ibritumomab tiuxetan intravenous, without BBB opening. There was good uptake of Indium-111 ibritumomab tiuxetan in tumor on SPECT scan after 48 h. Estimated radiation doses to brain around and distant from tumor were within safe limits. After Ytrium-90 ibritumomab tiuxetan there was CR in enhancing tumor where the BBB was leaky, but lesions occurred in other brain regions, where the BBB was intact during Yttrium-90 ibritumomab tiuxetan infusion. Imaging and dosimetry with Indium-111 ibritumomab tiuxetan and efficacy with Yttrium-90 ibritumomab tiuxetan suggest the need for future enhanced CNS delivery when using monoclonal or radiolabeled antibodies, as intravenous delivery alone may provide modest clinical benefit due to limited BBB permeability.

Original languageEnglish (US)
Pages (from-to)1712-1720
Number of pages9
JournalLeukemia and Lymphoma
Volume48
Issue number9
DOIs
Publication statusPublished - Sep 2007

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Keywords

  • Blood-brain barrier
  • Primary central nervous system lymphoma
  • Radioimmunotherapy

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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