131I-tositumomab (Bexxar®) vs.90Y-ibritumomab (Zevalin®) therapy of low-grade refractory/relapsed non-hodgkin lymphoma

Andrei Iagaru, Erik Mittra, Kristen Ganjoo, Susan J. Knox, Michael L. Goris

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Introduction: The American Cancer Society estimated 66,120 new cases of non-Hodgkin lymphoma (NHL) in the USA in 2008. Radioimmunotherapy has been shown in clinical trials to ® be an effective treatment for refractory/relapsed NHL. The available agents are Bexxar, a 131I ® radiolabeled murine monoclonal antibody and Zevalin, a 90Y radiolabeled murine antibody. Both target CD20 receptors present on the surface of lymphocytes. We present our clinical experience with Bexxar® and Zevalin® in the management of low-grade refractory or relapsed NHL. Methods: This is a retrospective study (Jan 2000-Jul 2006) of 67 patients with NHL, who were treated with Bexxar® (31 patients, group A) or Zevalin® (36 patients, group B) for refractory/relapsed disease. Group A included 16 men and 15 women, 35-81 years old (average, 59.3±13.4). Group B included 27 men and nine women, 36-85 years old (average, 55.4±13.8). Therapeutic doses ranged 40-138 mCi (average, 78.1±28.2) for Bexxar® and 17-34 mCi (average, 28.8±4.37) for Zevalin®. Results: Objective responses were induced in 22 of the 31 patients (70.9%) in group A and 28 of the 36 patients (77.8%) in group B. Complete response was noted in 11 patients (35.5%), partial response in seven patients (22.6%), and mixed response in four patients (12.9%) in group A. There were five patients (16.1%) with stable disease and four patients (12.9%) with disease progression in the same group. Complete response was noted in 15 patients (41.7%), partial response in nine patients (25%), and mixed response in four patients (11.1%) in group B. There were four patients (11.1%) with stable disease and another four patients (11.1%) with disease progression in the same group. The average decreases at posttherapy nadir were 36.9%±0.33 (group A) and 52.6%±0.32 (group B) for platelets, 27.8%±0.27 (group A) and 34.2%±0.38 (group B) for leukocytes, and 4.9%±0.15 (group A) and 7.6%±0.11 (group B) for hemoglobin. Grades 3 and 4 hematological toxicity occurred in 14 patients (45.2%) treated with Bexxar® and 22 patients (61.1%) treated with Zevalin®, but was reversible. Conclusion: Our study suggests that clinical practice of Bexxar® and Zevalin® radioimmunotherapy is an effective and safe adjunctive treatment for patients with NHL refractory/relapsed to conventional treatment. However, due to the small number of subjects, it was not possible to determine whether differences in the outcomes or toxicities from the two agents were statistically significant.

Original languageEnglish (US)
Pages (from-to)198-203
Number of pages6
JournalMolecular Imaging and Biology
Volume12
Issue number2
DOIs
StatePublished - Apr 1 2010
Externally publishedYes

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Non-Hodgkin's Lymphoma
Therapeutics
Radioimmunotherapy
ibritumomab tiuxetan
iodine-131 anti-B1 antibody
Disease Progression

Keywords

  • Bexxar
  • Lymphoma
  • Non-Hodgkin
  • Therapy
  • Zevalin

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

131I-tositumomab (Bexxar®) vs.90Y-ibritumomab (Zevalin®) therapy of low-grade refractory/relapsed non-hodgkin lymphoma. / Iagaru, Andrei; Mittra, Erik; Ganjoo, Kristen; Knox, Susan J.; Goris, Michael L.

In: Molecular Imaging and Biology, Vol. 12, No. 2, 01.04.2010, p. 198-203.

Research output: Contribution to journalArticle

Iagaru, Andrei ; Mittra, Erik ; Ganjoo, Kristen ; Knox, Susan J. ; Goris, Michael L. / 131I-tositumomab (Bexxar®) vs.90Y-ibritumomab (Zevalin®) therapy of low-grade refractory/relapsed non-hodgkin lymphoma. In: Molecular Imaging and Biology. 2010 ; Vol. 12, No. 2. pp. 198-203.
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abstract = "Introduction: The American Cancer Society estimated 66,120 new cases of non-Hodgkin lymphoma (NHL) in the USA in 2008. Radioimmunotherapy has been shown in clinical trials to {\circledR} be an effective treatment for refractory/relapsed NHL. The available agents are Bexxar, a 131I {\circledR} radiolabeled murine monoclonal antibody and Zevalin, a 90Y radiolabeled murine antibody. Both target CD20 receptors present on the surface of lymphocytes. We present our clinical experience with Bexxar{\circledR} and Zevalin{\circledR} in the management of low-grade refractory or relapsed NHL. Methods: This is a retrospective study (Jan 2000-Jul 2006) of 67 patients with NHL, who were treated with Bexxar{\circledR} (31 patients, group A) or Zevalin{\circledR} (36 patients, group B) for refractory/relapsed disease. Group A included 16 men and 15 women, 35-81 years old (average, 59.3±13.4). Group B included 27 men and nine women, 36-85 years old (average, 55.4±13.8). Therapeutic doses ranged 40-138 mCi (average, 78.1±28.2) for Bexxar{\circledR} and 17-34 mCi (average, 28.8±4.37) for Zevalin{\circledR}. Results: Objective responses were induced in 22 of the 31 patients (70.9{\%}) in group A and 28 of the 36 patients (77.8{\%}) in group B. Complete response was noted in 11 patients (35.5{\%}), partial response in seven patients (22.6{\%}), and mixed response in four patients (12.9{\%}) in group A. There were five patients (16.1{\%}) with stable disease and four patients (12.9{\%}) with disease progression in the same group. Complete response was noted in 15 patients (41.7{\%}), partial response in nine patients (25{\%}), and mixed response in four patients (11.1{\%}) in group B. There were four patients (11.1{\%}) with stable disease and another four patients (11.1{\%}) with disease progression in the same group. The average decreases at posttherapy nadir were 36.9{\%}±0.33 (group A) and 52.6{\%}±0.32 (group B) for platelets, 27.8{\%}±0.27 (group A) and 34.2{\%}±0.38 (group B) for leukocytes, and 4.9{\%}±0.15 (group A) and 7.6{\%}±0.11 (group B) for hemoglobin. Grades 3 and 4 hematological toxicity occurred in 14 patients (45.2{\%}) treated with Bexxar{\circledR} and 22 patients (61.1{\%}) treated with Zevalin{\circledR}, but was reversible. Conclusion: Our study suggests that clinical practice of Bexxar{\circledR} and Zevalin{\circledR} radioimmunotherapy is an effective and safe adjunctive treatment for patients with NHL refractory/relapsed to conventional treatment. However, due to the small number of subjects, it was not possible to determine whether differences in the outcomes or toxicities from the two agents were statistically significant.",
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T1 - 131I-tositumomab (Bexxar®) vs.90Y-ibritumomab (Zevalin®) therapy of low-grade refractory/relapsed non-hodgkin lymphoma

AU - Iagaru, Andrei

AU - Mittra, Erik

AU - Ganjoo, Kristen

AU - Knox, Susan J.

AU - Goris, Michael L.

PY - 2010/4/1

Y1 - 2010/4/1

N2 - Introduction: The American Cancer Society estimated 66,120 new cases of non-Hodgkin lymphoma (NHL) in the USA in 2008. Radioimmunotherapy has been shown in clinical trials to ® be an effective treatment for refractory/relapsed NHL. The available agents are Bexxar, a 131I ® radiolabeled murine monoclonal antibody and Zevalin, a 90Y radiolabeled murine antibody. Both target CD20 receptors present on the surface of lymphocytes. We present our clinical experience with Bexxar® and Zevalin® in the management of low-grade refractory or relapsed NHL. Methods: This is a retrospective study (Jan 2000-Jul 2006) of 67 patients with NHL, who were treated with Bexxar® (31 patients, group A) or Zevalin® (36 patients, group B) for refractory/relapsed disease. Group A included 16 men and 15 women, 35-81 years old (average, 59.3±13.4). Group B included 27 men and nine women, 36-85 years old (average, 55.4±13.8). Therapeutic doses ranged 40-138 mCi (average, 78.1±28.2) for Bexxar® and 17-34 mCi (average, 28.8±4.37) for Zevalin®. Results: Objective responses were induced in 22 of the 31 patients (70.9%) in group A and 28 of the 36 patients (77.8%) in group B. Complete response was noted in 11 patients (35.5%), partial response in seven patients (22.6%), and mixed response in four patients (12.9%) in group A. There were five patients (16.1%) with stable disease and four patients (12.9%) with disease progression in the same group. Complete response was noted in 15 patients (41.7%), partial response in nine patients (25%), and mixed response in four patients (11.1%) in group B. There were four patients (11.1%) with stable disease and another four patients (11.1%) with disease progression in the same group. The average decreases at posttherapy nadir were 36.9%±0.33 (group A) and 52.6%±0.32 (group B) for platelets, 27.8%±0.27 (group A) and 34.2%±0.38 (group B) for leukocytes, and 4.9%±0.15 (group A) and 7.6%±0.11 (group B) for hemoglobin. Grades 3 and 4 hematological toxicity occurred in 14 patients (45.2%) treated with Bexxar® and 22 patients (61.1%) treated with Zevalin®, but was reversible. Conclusion: Our study suggests that clinical practice of Bexxar® and Zevalin® radioimmunotherapy is an effective and safe adjunctive treatment for patients with NHL refractory/relapsed to conventional treatment. However, due to the small number of subjects, it was not possible to determine whether differences in the outcomes or toxicities from the two agents were statistically significant.

AB - Introduction: The American Cancer Society estimated 66,120 new cases of non-Hodgkin lymphoma (NHL) in the USA in 2008. Radioimmunotherapy has been shown in clinical trials to ® be an effective treatment for refractory/relapsed NHL. The available agents are Bexxar, a 131I ® radiolabeled murine monoclonal antibody and Zevalin, a 90Y radiolabeled murine antibody. Both target CD20 receptors present on the surface of lymphocytes. We present our clinical experience with Bexxar® and Zevalin® in the management of low-grade refractory or relapsed NHL. Methods: This is a retrospective study (Jan 2000-Jul 2006) of 67 patients with NHL, who were treated with Bexxar® (31 patients, group A) or Zevalin® (36 patients, group B) for refractory/relapsed disease. Group A included 16 men and 15 women, 35-81 years old (average, 59.3±13.4). Group B included 27 men and nine women, 36-85 years old (average, 55.4±13.8). Therapeutic doses ranged 40-138 mCi (average, 78.1±28.2) for Bexxar® and 17-34 mCi (average, 28.8±4.37) for Zevalin®. Results: Objective responses were induced in 22 of the 31 patients (70.9%) in group A and 28 of the 36 patients (77.8%) in group B. Complete response was noted in 11 patients (35.5%), partial response in seven patients (22.6%), and mixed response in four patients (12.9%) in group A. There were five patients (16.1%) with stable disease and four patients (12.9%) with disease progression in the same group. Complete response was noted in 15 patients (41.7%), partial response in nine patients (25%), and mixed response in four patients (11.1%) in group B. There were four patients (11.1%) with stable disease and another four patients (11.1%) with disease progression in the same group. The average decreases at posttherapy nadir were 36.9%±0.33 (group A) and 52.6%±0.32 (group B) for platelets, 27.8%±0.27 (group A) and 34.2%±0.38 (group B) for leukocytes, and 4.9%±0.15 (group A) and 7.6%±0.11 (group B) for hemoglobin. Grades 3 and 4 hematological toxicity occurred in 14 patients (45.2%) treated with Bexxar® and 22 patients (61.1%) treated with Zevalin®, but was reversible. Conclusion: Our study suggests that clinical practice of Bexxar® and Zevalin® radioimmunotherapy is an effective and safe adjunctive treatment for patients with NHL refractory/relapsed to conventional treatment. However, due to the small number of subjects, it was not possible to determine whether differences in the outcomes or toxicities from the two agents were statistically significant.

KW - Bexxar

KW - Lymphoma

KW - Non-Hodgkin

KW - Therapy

KW - Zevalin

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