Radioimmunotherapy consolidation using ¹³¹I-tositumomab for patients with chronic lymphocytic leukemia or small lymphocytic lymphoma in first remission

Abstract

Despite initial responses to chemoimmunotherapy, relapse and minimal residual disease (MRD) remain major issues in treatment of CLL/SLL patients. We administered 131I-tositumomab to patients in CR or PR after induction chemotherapy. Toxicities and rate of PR to CR conversion and MRD elimination were assessed three months later. The study stopped prematurely after enrolling 16 patients .Four (25%) were in CR, 12 (75%) in PR, and 12 (75%) had MRD. Three months after treatment with 131I-tositumomab, CR was achieved (n=8; 50%) or sustained (n=4; 25%) in 12 patients and MRD was eliminated in 4 of 12 patients (33%). Hematologic toxicities were anemia in 1 patient (6%), neutropenia in 13 (81%), and thrombocytopenia in 8 (50%). Two patients (12%) developed MDS 17 and 20 months after consolidation. Consolidation with 131I-tositumomab for CLL/SLL patients in first remission is feasible and may provide the benefit of converting PR to CR and/or eliminating MRD.

The role of 18F-FDG PET/CT in patients with diffuse large B-cell lymphoma after radioimmunotherapy using 131I-rituximab as consolidation therapy

“…90 Y-ibritumomab (Zevalin, Spectrum Pharmaceuticals) is the only RIT currently approved in Europe, and its successful use in consolidation treatment following chemotherapy has been well documented in patients with follicular lymphoma (FL), and chronic lymphocytic leukemia (CLL) [ 6 , 7 ]. The use of 131 I-tositumomab (Bexxar, GlaxoSmithKline) as a consolidation therapy has also been reported in CLL, advanced DLBCL, and FL [ 8 – 10 ]. Meanwhile, a study using rituximab as a consolidation therapy was conducted in a phase 2 clinical study at our institution [ 11 ].…”

Re-188 Enhances the Inhibitory Effect of Bevacizumab in Non-Small-Cell Lung Cancer

“…Coupled to 131 I, tositumomab has been used to treat chronic lymphocytic leukemia or small lymphocytic lymphoma in first remission. Also, patients with leukemias or lymphomas enjoyed more survival benefits from RIT than without RIT treatment [13][14][15]. However, for solid tumor, which are radio-resistant and less accessible to MAbs, a concern remains about limited clinical efficacy [16].…”

Monoclonal Antibodies for the Treatment of Cancer

“…This agent is administered to patients with metastatic colorectal cancer to view the extent of metastatic development (39-42); (ii) Ibritumomab tiuxetan is a murine MAB which is labeled with yttrium 90 or Indium 111. These radioactive agents are used for the treatment of patients with non-Hodgkin's lymphoma and often used together with Rituximab which was discussed above (43-45); (iii) Capromab pendetide, a murine MAB, targets prostate membranes and is used to diagnose prostate cancer or determine the extent of cancer eradication following prostatectomy (46)(47)(48); (iv) Tositumomab is a MAB labeled with iodine 131 and is used to treat patients with non-Hodgkin's lymphoma who are unresponsive to standard chemotherapy (49)(50)(51)(52) .…”