Radioimmunotherapy of Lymphoma: Bexxar and Zevalin

  • S.J. G
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Abstract

Radioimmunotherapy is a form of targeted radionuclide therapy that uses a monoclonal antibody to deliver localized radiation. It is most appropriate for treatment of multiple tumor sites that cannot be readily excised surgically or irradiated using external beam radiation or brachytherapy. At present, 2 products, Bexxar (131I-tositumomab and unlabeled tositumomab, GlaxoSmithKline, Triangle Park, NC) and Zevalin (90Y-ibritumomab tiuxetan and unlabeled rituximab, Spectrum Pharmaceuticals, Irvine, CA and Cell Therapeutics, Seattle, WA) are approved for treatment of non-Hodgkin's lymphoma in certain clinical situations in the United States and Canada. Zevalin is available also in Europe, and there are plans to make both agents more widely available. The therapeutic dose to be used depends upon a number of patient-specific variables. Both regimen achieve a complete response or partial response in approximately 3 of 4 patients, with a duration of remission lasting many years in some cases. This article reviews the basis for dose selection, the nuclear medicine procedures involved, the results obtained to date, and issues related to patient and staff safety. © 2010 Elsevier Inc. All rights reserved.

Author-supplied keywords

  • B cell lymphoma
  • B lymphocyte
  • CD20 antigen
  • acetylsalicylic acid
  • anthracycline
  • antigen recognition
  • antihistaminic agent
  • antineoplastic agent
  • antipyretic agent
  • aspirin
  • bexxar
  • blood pressure
  • bone marrow suppression
  • cancer chemotherapy
  • cancer immunotherapy
  • cancer patient
  • cancer radiotherapy
  • cancer regression
  • cancer survival
  • chill
  • clinical protocol
  • clinical trial
  • cyclophosphamide
  • diphenhydramine
  • dizziness
  • dose calculation
  • dosimetry
  • doxorubicin
  • drug approval
  • drug blood level
  • drug distribution
  • drug dose sequence
  • drug efficacy
  • drug indication
  • dyspnea
  • fatigue
  • febrile neutropenia
  • flu like syndrome
  • fludarabine
  • fluorodeoxyglucose f 18
  • follicular lymphoma
  • granulocyte colony stimulating factor receptor
  • human
  • ibritumomab tiuxetan
  • multiple cycle treatment
  • nausea
  • neutropenia
  • nonhodgkin lymphoma
  • nonsteroid antiinflammatory agent
  • paracetamol
  • patient monitoring
  • patient selection
  • platinum derivative
  • potassium iodide
  • prednisone
  • radiation dose
  • radiation dose fractionation
  • radiation protection
  • radiation safety
  • radioimmunotherapy
  • radioisotope therapy
  • review
  • rituxan
  • rituximab
  • side effect
  • stem cell transplantation
  • tositumomab
  • tositumomab i 131
  • tumor localization
  • urticaria
  • vincristine sulfate
  • zevalin

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Authors

  • Goldsmith S.J.

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