Advancing Radioimmunotherapy and Its Future Role in Non-Hodgkin Lymphoma

Abstract

Radioimmunotherapy is an effective treatment modality with an acceptable toxicity profile in both indolent B-cell non-Hodgkin lymphoma and histologic transformation. Its ease of administration from a patient's perspective sets it apart from chemoimmunotherapy regimens. It has demonstrated efficacy in a range of different treatment scenarios. Despite its promise as a treatment modality, radioimmunotherapy has been seldom used, and one of the previously available agents is now off the market. Radioimmunotherapy has shown impressive activity in both the relapsed and upfront settings in follicular lymphoma, histologic transformation, as consolidation after chemotherapy, and in conjunction with high-dose chemotherapy and autologous stem cell support. Future efforts should focus on its optimal employment in the upfront setting for follicular lymphoma as well as further investigation of the promising activity in histologic transformation.

Update on follicular lymphoma

“…34 For the response-adapted arm, patients with a complete metabolic response on PET who were MRD undetected were observed; those with detectable MRD received rituximab x 4 and then were reassessed. Patients without complete metabolic response received radioimmunotherapy 35 prior to rituximab maintenance. Randomization of over 800 patients occurred after six cycles of either RCHOP or BR induction therapy.…”

Zastosowanie radioimmunoterapii w leczeniu chłoniaków

“…wykazało 87% skuteczność terapii preparatem Zevalin oraz 25,5 miesiąca okresu wstrzymanej progresji u chorych z rozpoznanym FL [15]. Według autorów [13,16], użycie preparatu 131 I-Tositumab, pozwala uzyskać skuteczność terapii w 95% przypadkach, i pięcioletnie przeżycia na poziomie 60% [13,16]. Powyższe dane mogą sugerować, że zastosowanie RIT jako wyłącznej metody terapeutycznej, może prowadzić do wyleczenia choroby i uzyskania zadowalających długoterminowych efektów terapeutycznych.…”

Combination of 131I-trastuzumab and lanatoside C enhanced therapeutic efficacy in HER2 positive tumor model

“…Currently, the targeted radiation delivered by mAbs kills explicitly cancer cells or the tumor microenvironment 3 . RIT have been used primarily for the treatment of lymphoma, mostly with radiolabeled mAbs against CD20 4 – 7 . Moreover, Knox et al 8 have shown that RIT is more effective than external beam radiation therapy in animal models.…”