Durable remissions from fludarabine followed by the iodine I-131 tositumomab Bexxar therapeutic regimen for patients with previously untreated follicular non-Hodgkin's lymphoma (NHL)

Leonard, John P.; Coleman, Michael J.; Kostakoğlu, Lale; Chadburn, Amy; Fiore, J. M.; Furman, Richard R.; Schuster, Michael W.; Kroll, Stewart; Goldsmith, Scott J.

doi:10.1200/jco.2004.22.14_suppl.6518

Cited by 5 publications

(9 citation statements)

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“…No systematic reviews, meta-analyses, or evidence-based practice guidelines were identified. We divided the trials into two categories based on patient treatment history: previously untreated 25,27,29,31,35 and previously treated patients with nhl. The "previously treated" category was further divided into randomized 22 and single-arm trials of 131 I-tositumomab.…”

Section: Resultsmentioning

confidence: 99%

“…In the four trials of 131 I-tositumomab alone 35 or after chemotherapy 25,29,31 , objective response rates ranged from 90% to 100%, with cr rates from 67% to 83%. In a trial of sequential therapy with 131 I-tositumomab followed by chop (cyclophosphamide, doxorubicin, vincristine, prednisone) chemotherapy (×6 cycles) in patients with mantle-cell nhl, the response rate was 83% after 131 I-tositumomab (cr rate: 50%) and by intention-totreat analysis, the response rate was 75% after chop (all of which were crs) 27 .…”

Section: 23mentioning

confidence: 99%

“…All of the five studies located were single-arm noncomparative phase ii trials with sample sizes ranging from 13 patients to 90 patients 25,27,29,31,35 . Median follow-up ranged from 11 months to 61.2 months.…”

Section: Study Qualitymentioning

confidence: 99%

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131I–Tositumomab in Lymphoma

et al. 2009

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Radioimmunoconjugates are radioisotope-bound monoclonal antibodies that target radiation specifically to sites of lymphoma involvement. Initial studies of 131 I-tositumomab in non-Hodgkin lymphoma (nhl) have suggested benefit in patients with relapsed or refractory indolent disease. However, the routine adoption of this agent is tempered by concerns about associated toxicities and unclear long-term benefit. Based on a comprehensive search for studies on 131 I-tositumomab use in lymphoma, this systematic review summarizes and evaluates the evidence on• the benefits and risks of this novel therapy, • the predictors for response and toxicity, and • the role of dosimetry and imaging studies before treatment.We identified 18 trials investigating the use of 131 I-tositumomab for the treatment of adult patients with nhl. In trials of patients with relapsed or refractory indolent nhl, overall response rates ranged from 67% to 83%. In patients with follicular nhl refractory to the monoclonal antibody rituximab, response rates remained high (65%-72%). However, in rituximabnaïve patients with relapsed or refractory indolent or transformed nhl, improvements in time to progression or survival have not been clearly established. 131 I-Tositumomab is an active agent in relapsed and refractory non-Hodgkin lymphoma that should be considered in selected patients.

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Section: Resultsmentioning

confidence: 99%

Section: 23mentioning

confidence: 99%

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131I–Tositumomab in Lymphoma

et al. 2009

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“…Study CP-98-025 (n ϭ 11 patients) was a single-center trial that used an abbreviated course of 3 cycles of fludarabine followed by iodine I-131 tositumomab in patients with previously untreated LG NHL. 21 Study CP-99-032 (n ϭ 1 patient) was a multicenter, Phase II study that evaluated iodine I-131 tositumomab in patients with diffuse large B-cell NHL who were in response after standard CHOP chemotherapy. Finally, Study CP-99-036 (n ϭ 4) was a multicenter study that evaluated 6 cycles of cyclophosphamide, vincristine, and prednisone chemotherapy followed by iodine I-131 tositumomab as initial therapy for patients with LG NHL.…”

Section: Methodsmentioning

confidence: 99%

Subsequent therapy can be administered after tositumomab and iodine I‐131 tositumomab for non‐Hodgkin lymphoma

Dosik

Coleman

Kostakoğlu

et al. 2005

Cancer

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BACKGROUND Iodine I‐131 tositumomab is a well tolerated and effective therapy for recurrent low‐grade and transformed low‐grade non‐Hodgkin lymphoma (NHL). Hematologic reserve after radioimmunotherapy (RIT) is an important consideration when subsequent therapy is required. METHODS One hundred fifty‐five patients who received treatment with I‐131 tositumomab were assessed, and 68 patients had progressive disease after RIT. The median age (n = 68 patients) was 59 years (range,18–82 yrs), and patients received a median of 2 pre‐RIT regimens (range,1–8 regimens), including 66% who received anthracycline, 19% who received platinum, and 50% who received fludarabine. RESULTS The median time to disease progression (among progressors) was 168 days (range, 19–771 days). At the time they developed recurrent disease, patients had median white blood cell count (WBC) of 4.9 K cells/μL (range, 1.1–21.4 K cells/μL), a median absolute neutrophil count (ANC) of 3.25 K cells/μL (range, 0.59–8.20 K cells/μL), a median platelet count of 130 K cells/μL (range, 9–440 K cells/μL), and there was no significant difference between pre‐RIT and recurrence values except for the platelet count (P < 0.05). No patient demonstrated a WBC < 1.0 K cells/μL or an ANC < 0.5 K cells/μL, although 1 patient had a platelet count < 10 K cells/μL. Twenty‐four patients subsequently received no further chemotherapy; and, in 21 patients (88%), hematologic parameters appeared to allow subsequent chemotherapy if necessary (blood counts: National Cancer Institute Grade 0–2). Among 44 patients (65%) who received further chemotherapy (median, 2 regimens; range, 1–4 regimens), 19 patients (43%) were treated with anthracyclines, 17 patients (39%) were treated with platinum, 10 patients (23%) were treated with fludarabine, and 13 patients (30%) underwent stem cell transplantation. Disease improvement occurred in most patients, although 18 patients died (40%) after further chemotherapy, predominantly from refractory lymphoma. CONCLUSIONS Most patients with progressive disease after treatment with iodine I‐131 tositumomab were able to receive subsequent therapy, including cytotoxic chemotherapy and stem cell transplantation. Cancer 2006. © 2005 American Cancer Society.

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“…This sequential regimen (CHOP-131 I-T) is now tested in a randomized fashion against CHOPrituximab. The same RIC was tested after an abbreviated 3-cycle course of fludarabine 70 again as first-line treatment. The sequence induced a complete response in 83% of the 35 evaluable patients.…”

Section: Indolent Nhlmentioning

confidence: 99%

Radioimmunotherapy for Non-Hodgkin Lymphoma : Historical Perspective and Current Status

Emmanouilides

2007

J Clin Exp Hematopathol

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90 Y-ibritumomab tiuxetan utilizes a monoclonal anti-CD20 antibody to deliver b-emitting yttium-90 to the malignant B-cells. Clinical trials have demonstrated its efficacy, which is largely independent of the intrinsic activity of the anti-CD20 antibody. A similar anti-CD20 radiotherapeutic compound, 131 I-tositumomab, was subsequently approved in the USA. The advantages of increased efficacy compared to the naked antibody are gained at the expense of myelotoxicity which is dose limiting but reversible. Studies exploring expanded applications of radioimmunotherapy have been recently completed or are under way. It is hoped that RIT will be an ideal agent for consolidation after chemotherapy for both indolent and aggressive non-Hodgkin lymphoma as well as a useful addition to preparatory high dose regimens prior to transplant. RIT has been shown to be an effective and clinically relevant complementary therapeutic approach for patients with lymphoma. 〔J Clin Exp Hematopathol 47(2) : 43-60, 2007〕

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Durable remissions from fludarabine followed by the iodine I-131 tositumomab Bexxar therapeutic regimen for patients with previously untreated follicular non-Hodgkin's lymphoma (NHL)

Cited by 5 publications

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131I–Tositumomab in Lymphoma

131I–Tositumomab in Lymphoma

Subsequent therapy can be administered after tositumomab and iodine I‐131 tositumomab for non‐Hodgkin lymphoma

Radioimmunotherapy for Non-Hodgkin Lymphoma : Historical Perspective and Current Status

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