Radioimmunotherapy of B-cell non-Hodgkin's lymphoma

Abstract

In the past decade, several new antibody-based therapies - using either radiolabelled or unlabelled monoclonal antibodies - have become available for the treatment of patients with refractory or recurrent non-Hodgkin's lymphoma (NHL). Unlabelled monoclonal antibodies (mAbs) kill lymphoma cells by activating host immune effector mechanisms, or by inducing apoptosis. These mAbs can also be used to guide radionuclides to the lymphoma. This radioimmunotherapy (RIT) has been studied with various nuclides (131I, 90Y, 67Cu and 186Re) and with various mAbs. In this review the radionuclides, methods of dosing and recent RIT studies in patients with B-cell NHL are reviewed. Most of these studies demonstrate that RIT is an effective new treatment modality for NHL.

In vivo imaging and radioiodine therapy following sodium iodide symporter gene transfer in animal model of intracerebral gliomas

“…20 Therefore, there is much interest to develop genetically targeted radionuclide therapy for selected tumors. 21 Clinical translation of this approach awaits extensive investigations on biodistribution of the selected radionuclides in vivo, as well as detailed dosimetry data to evaluate the therapeutic efficacy versus normal tissue radiotoxicity.…”

Radioimmunotherapy with 177Lu-DOTA-Rituximab: Final Results of a Phase I/II Study in 31 Patients with Relapsing Follicular, Mantle Cell, and Other Indolent B-Cell Lymphomas

“…Blood tests were performed weekly up to week 10 or until recovery from nadir. Wholebody contrast-enhanced CT and 18 F-FDG PET or 18 FDG PET/CT was performed at baseline and 8-12 wk after treatment. The International Workshop Criteria and PET-based response criteria were used for response assessment (24).…”

“…One patient died before reevaluation. In another patient, 18 F-FDG PET/CT scans were not repeated but the patient was evaluable for clinical follow-up. Results are summarized in Table 3.…”

“…In addition, 177 Lu emits g-radiation (113 keV, 7%; 208 keV, 11%) that can be used for scintigraphic imaging, allowing immediate control of distribution and dosimetry in treated patients. The fraction and energy of its g-emissions are lower than those of 131 I (362 keV), whose physical characteristics necessitate a prolonged hospital stay for treated patients in many countries (18).…”

Safety and Efficacy of I(131) Tositumomab in the Treatment of non-Hodgkin's Lymphoma

“…44, 45 Goldenberg and colleagues for examples commented that as RIT has two potentially therapeutic arms, namely radiation and mAb mechanisms, poor radiation targeting does not exclude a good therapeutic response from the mAb. 45 …”