Treatment with ibritumomab tiuxetan radioimmunotherapy in patients with rituximab-refractory follicular non-Hodgkin's lymphoma
Identifieur interne : 00E764 ( Main/Repository ); précédent : 00E763; suivant : 00E765Treatment with ibritumomab tiuxetan radioimmunotherapy in patients with rituximab-refractory follicular non-Hodgkin's lymphoma
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Abstract
Purpose: Rituximab is commonly used as a single agent or in combination therapy for non-Hodgkin's lymphoma (NHL). Ibritumomab tiuxetan radioimmunotherapy targets the same antigen as rituximab and has demonstrated efficacy in rituximab-naive NHL. This study evaluated ibritumomab tiuxetan in the treatment of rituximab-refractory follicular NHL. Patients and Methods: Eligible patients were refractory to rituximab; this was defined as no objective response to rituximab (375 mg/m2 weekly for 4 weeks) or time to progression (TTP) of ≤ 6 months. The ibritumomab tiuxetan treatment regimen consisted of pretreatment with rituximab (250 mg/m2 intravenously on days 1 and 8) to deplete peripheral blood B cells, then yttrium-90 ibritumomab tiuxetan (0.4 mCi/ kg; maximum, 32 mCi) intravenously on day 8, administered on an outpatient basis. An imaging/dosimetry dose of indium-111 ibritumomab tiuxetan (5 mCi) was injected after rituximab (day 1) in 28 patients. Results: Fifty-seven patients were treated. The median age was 54 years, 74% had tumors ≥ 5 cm, and all were extensively pretreated (median, four prior therapies; range, one to nine). The estimated radiation-absorbed doses to healthy organs were below the study-defined limit in all patients studied with dosimetry. The overall response rate for the 54 patients with follicular NHL was 74% (15% complete responses and 59% partial responses). The Kaplan-Meier-estimated TTP was 6.8 months (range, 1.1 to ≥ 25.9 months) for all patients and 8.7 months for responders. Adverse events were primarily hematologic; the incidence of grade 4 neutropenia, thrombocytopenia, and anemia was 35%, 9%, and 4%, respectively. Conclusion: Ibritumomab tiuxetan radioimmunotherapy is effective in rituximab-refractory patients. The only significant toxicity is hematologic.
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en" level="a">Treatment with ibritumomab tiuxetan radioimmunotherapy in patients with rituximab-refractory follicular non-Hodgkin's lymphoma</title><author><name sortKey="Witzig, Thomas E" uniqKey="Witzig T">Thomas E. Witzig</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Mayo Clinic</s1><s2>Rochester, MN</s2><s3>USA</s3></inist:fA14><country>États-Unis</country><wicri:noRegion>Mayo Clinic</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Johns Hopkins Oncology Center</s1><s2>Baltimore, MD</s2><s3>USA</s3></inist:fA14><country>États-Unis</country><wicri:noRegion>Johns Hopkins Oncology Center</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Northwestern University/Robert H. Lurie Cancer Center</s1><s2>Chicago, IL</s2><s3>USA</s3></inist:fA14><country>États-Unis</country><wicri:noRegion>Northwestern University/Robert H. Lurie Cancer Center</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>University of California</s1><s2>Los Angeles</s2><s3>USA</s3></inist:fA14><country>États-Unis</country><wicri:noRegion>University of California</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>IDEC Pharmaceaticals Corporation</s1><s2>San Diego, CA</s2><s3>USA</s3></inist:fA14><country>États-Unis</country><placeName><region type="state">Idaho</region></placeName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>Roswell Park Cancer Institute</s1><s2>Buffalo, NY</s2><s3>USA</s3></inist:fA14><country>États-Unis</country><wicri:noRegion>Roswell Park Cancer Institute</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="07"><s1>University of Alabama</s1><s2>Birmingham, AL</s2><s3>USA</s3></inist:fA14><country>États-Unis</country><wicri:noRegion>University of Alabama</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="08"><s1>Indiana Cancer Pavilion</s1><s2>Indianapolis, IN</s2><s3>USA</s3></inist:fA14><country>États-Unis</country><wicri:noRegion>Indiana Cancer Pavilion</wicri:noRegion></affiliation></author><author><name sortKey="Flinn, Ian W" uniqKey="Flinn I">Ian W. Flinn</name></author><author><name sortKey="Gordon, Leo I" uniqKey="Gordon L">Leo I. Gordon</name></author><author><name sortKey="Emmanouilides, Christos" uniqKey="Emmanouilides C">Christos Emmanouilides</name></author><author><name sortKey="Czuczman, Myron S" uniqKey="Czuczman M">Myron S. Czuczman</name></author><author><name sortKey="Saleh, Mansoor N" uniqKey="Saleh M">Mansoor N. Saleh</name></author><author><name sortKey="Cripe, Larry" uniqKey="Cripe L">Larry Cripe</name></author><author><name sortKey="Wiseman, Gregory" uniqKey="Wiseman G">Gregory Wiseman</name></author><author><name sortKey="Olejnik, Teresa" uniqKey="Olejnik T">Teresa Olejnik</name></author><author><name sortKey="Multani, Pratik S" uniqKey="Multani P">Pratik S. Multani</name></author><author><name sortKey="White, Christine A" uniqKey="White C">Christine A. White</name></author></titleStmt><publicationStmt><idno type="inist">02-0468942</idno><date when="2002">2002</date><idno type="stanalyst">PASCAL 02-0468942 INIST</idno><idno type="RBID">Pascal:02-0468942</idno><idno type="wicri:Area/Main/Corpus">00E863</idno><idno type="wicri:Area/Main/Repository">00E764</idno></publicationStmt><seriesStmt><idno type="ISSN">0732-183X</idno><title level="j" type="abbreviated">J. clin. oncol.</title><title level="j" type="main">Journal of clinical oncology</title></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Complication</term><term>Follicular lymphoma</term><term>Human</term><term>Ibritumomab tiuxetan</term><term>Immunoconjugate</term><term>Immunoradiotherapy</term><term>Monoclonal antibody</term><term>Radioisotope</term><term>Treatment</term><term>Yttrium</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Lymphome folliculaire</term><term>Ibritumomab tiuxétan</term><term>Anticorps monoclonal</term><term>Immunoconjugué</term><term>Immunoradiothérapie</term><term>Yttrium</term><term>Radioisotope</term><term>Traitement</term><term>Complication</term><term>Homme</term></keywords><keywords scheme="Wicri" type="concept" xml:lang="fr"><term>Homme</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Purpose: Rituximab is commonly used as a single agent or in combination therapy for non-Hodgkin's lymphoma (NHL). Ibritumomab tiuxetan radioimmunotherapy targets the same antigen as rituximab and has demonstrated efficacy in rituximab-naive NHL. This study evaluated ibritumomab tiuxetan in the treatment of rituximab-refractory follicular NHL. Patients and Methods: Eligible patients were refractory to rituximab; this was defined as no objective response to rituximab (375 mg/m<sup>2</sup> weekly for 4 weeks) or time to progression (TTP) of ≤ 6 months. The ibritumomab tiuxetan treatment regimen consisted of pretreatment with rituximab (250 mg/m<sup>2</sup> intravenously on days 1 and 8) to deplete peripheral blood B cells, then yttrium-90 ibritumomab tiuxetan (0.4 mCi/ kg; maximum, 32 mCi) intravenously on day 8, administered on an outpatient basis. An imaging/dosimetry dose of indium-111 ibritumomab tiuxetan (5 mCi) was injected after rituximab (day 1) in 28 patients. Results: Fifty-seven patients were treated. The median age was 54 years, 74% had tumors ≥ 5 cm, and all were extensively pretreated (median, four prior therapies; range, one to nine). The estimated radiation-absorbed doses to healthy organs were below the study-defined limit in all patients studied with dosimetry. The overall response rate for the 54 patients with follicular NHL was 74% (15% complete responses and 59% partial responses). The Kaplan-Meier-estimated TTP was 6.8 months (range, 1.1 to ≥ 25.9 months) for all patients and 8.7 months for responders. Adverse events were primarily hematologic; the incidence of grade 4 neutropenia, thrombocytopenia, and anemia was 35%, 9%, and 4%, respectively. Conclusion: Ibritumomab tiuxetan radioimmunotherapy is effective in rituximab-refractory patients. The only significant toxicity is hematologic.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0732-183X</s0></fA01><fA03 i2="1"><s0>J. clin. oncol.</s0></fA03><fA05><s2>20</s2></fA05><fA06><s2>15</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Treatment with ibritumomab tiuxetan radioimmunotherapy in patients with rituximab-refractory follicular non-Hodgkin's lymphoma</s1></fA08><fA11 i1="01" i2="1"><s1>WITZIG (Thomas E.)</s1></fA11><fA11 i1="02" i2="1"><s1>FLINN (Ian W.)</s1></fA11><fA11 i1="03" i2="1"><s1>GORDON (Leo I.)</s1></fA11><fA11 i1="04" i2="1"><s1>EMMANOUILIDES (Christos)</s1></fA11><fA11 i1="05" i2="1"><s1>CZUCZMAN (Myron S.)</s1></fA11><fA11 i1="06" i2="1"><s1>SALEH (Mansoor N.)</s1></fA11><fA11 i1="07" i2="1"><s1>CRIPE (Larry)</s1></fA11><fA11 i1="08" i2="1"><s1>WISEMAN (Gregory)</s1></fA11><fA11 i1="09" i2="1"><s1>OLEJNIK (Teresa)</s1></fA11><fA11 i1="10" i2="1"><s1>MULTANI (Pratik S.)</s1></fA11><fA11 i1="11" i2="1"><s1>WHITE (Christine A.)</s1></fA11><fA14 i1="01"><s1>Mayo Clinic</s1><s2>Rochester, MN</s2><s3>USA</s3></fA14><fA14 i1="02"><s1>Johns Hopkins Oncology Center</s1><s2>Baltimore, MD</s2><s3>USA</s3></fA14><fA14 i1="03"><s1>Northwestern University/Robert H. Lurie Cancer Center</s1><s2>Chicago, IL</s2><s3>USA</s3></fA14><fA14 i1="04"><s1>University of California</s1><s2>Los Angeles</s2><s3>USA</s3></fA14><fA14 i1="05"><s1>IDEC Pharmaceaticals Corporation</s1><s2>San Diego, CA</s2><s3>USA</s3></fA14><fA14 i1="06"><s1>Roswell Park Cancer Institute</s1><s2>Buffalo, NY</s2><s3>USA</s3></fA14><fA14 i1="07"><s1>University of Alabama</s1><s2>Birmingham, AL</s2><s3>USA</s3></fA14><fA14 i1="08"><s1>Indiana Cancer Pavilion</s1><s2>Indianapolis, IN</s2><s3>USA</s3></fA14><fA20><s1>3262-3269</s1></fA20><fA21><s1>2002</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>20094</s2><s5>354000109010160150</s5></fA43><fA44><s0>0000</s0><s1>© 2002 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>33 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>02-0468942</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>Journal of clinical oncology</s0></fA64><fA66 i1="01"><s0>USA</s0></fA66><fC01 i1="01" l="ENG"><s0>Purpose: Rituximab is commonly used as a single agent or in combination therapy for non-Hodgkin's lymphoma (NHL). Ibritumomab tiuxetan radioimmunotherapy targets the same antigen as rituximab and has demonstrated efficacy in rituximab-naive NHL. This study evaluated ibritumomab tiuxetan in the treatment of rituximab-refractory follicular NHL. Patients and Methods: Eligible patients were refractory to rituximab; this was defined as no objective response to rituximab (375 mg/m<sup>2</sup> weekly for 4 weeks) or time to progression (TTP) of ≤ 6 months. The ibritumomab tiuxetan treatment regimen consisted of pretreatment with rituximab (250 mg/m<sup>2</sup> intravenously on days 1 and 8) to deplete peripheral blood B cells, then yttrium-90 ibritumomab tiuxetan (0.4 mCi/ kg; maximum, 32 mCi) intravenously on day 8, administered on an outpatient basis. An imaging/dosimetry dose of indium-111 ibritumomab tiuxetan (5 mCi) was injected after rituximab (day 1) in 28 patients. Results: Fifty-seven patients were treated. The median age was 54 years, 74% had tumors ≥ 5 cm, and all were extensively pretreated (median, four prior therapies; range, one to nine). The estimated radiation-absorbed doses to healthy organs were below the study-defined limit in all patients studied with dosimetry. The overall response rate for the 54 patients with follicular NHL was 74% (15% complete responses and 59% partial responses). The Kaplan-Meier-estimated TTP was 6.8 months (range, 1.1 to ≥ 25.9 months) for all patients and 8.7 months for responders. Adverse events were primarily hematologic; the incidence of grade 4 neutropenia, thrombocytopenia, and anemia was 35%, 9%, and 4%, respectively. Conclusion: Ibritumomab tiuxetan radioimmunotherapy is effective in rituximab-refractory patients. The only significant toxicity is hematologic.</s0></fC01><fC02 i1="01" i2="X"><s0>002B26J</s0></fC02><fC03 i1="01" i2="X" l="FRE"><s0>Lymphome folliculaire</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="ENG"><s0>Follicular lymphoma</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="SPA"><s0>Linfoma folicular</s0><s5>01</s5></fC03><fC03 i1="02" i2="X" l="FRE"><s0>Ibritumomab tiuxétan</s0><s2>NK</s2><s2>FR</s2><s5>04</s5></fC03><fC03 i1="02" i2="X" l="ENG"><s0>Ibritumomab tiuxetan</s0><s2>NK</s2><s2>FR</s2><s5>04</s5></fC03><fC03 i1="02" i2="X" l="SPA"><s0>Ibritumomab tiuxetán</s0><s2>NK</s2><s2>FR</s2><s5>04</s5></fC03><fC03 i1="03" i2="X" l="FRE"><s0>Anticorps monoclonal</s0><s5>05</s5></fC03><fC03 i1="03" i2="X" l="ENG"><s0>Monoclonal antibody</s0><s5>05</s5></fC03><fC03 i1="03" i2="X" l="SPA"><s0>Anticuerpo monoclonal</s0><s5>05</s5></fC03><fC03 i1="04" i2="X" l="FRE"><s0>Immunoconjugué</s0><s5>06</s5></fC03><fC03 i1="04" i2="X" l="ENG"><s0>Immunoconjugate</s0><s5>06</s5></fC03><fC03 i1="04" i2="X" l="SPA"><s0>Inmunoconjugado</s0><s5>06</s5></fC03><fC03 i1="05" i2="X" l="FRE"><s0>Immunoradiothérapie</s0><s5>07</s5></fC03><fC03 i1="05" i2="X" l="ENG"><s0>Immunoradiotherapy</s0><s5>07</s5></fC03><fC03 i1="05" i2="X" l="SPA"><s0>Inmunoradioterapia</s0><s5>07</s5></fC03><fC03 i1="06" i2="X" l="FRE"><s0>Yttrium</s0><s2>NC</s2><s5>08</s5></fC03><fC03 i1="06" i2="X" l="ENG"><s0>Yttrium</s0><s2>NC</s2><s5>08</s5></fC03><fC03 i1="06" i2="X" l="SPA"><s0>Ytrio</s0><s2>NC</s2><s5>08</s5></fC03><fC03 i1="07" i2="X" l="FRE"><s0>Radioisotope</s0><s5>09</s5></fC03><fC03 i1="07" i2="X" l="ENG"><s0>Radioisotope</s0><s5>09</s5></fC03><fC03 i1="07" i2="X" l="SPA"><s0>Radionúclido</s0><s5>09</s5></fC03><fC03 i1="08" i2="X" l="FRE"><s0>Traitement</s0><s5>10</s5></fC03><fC03 i1="08" i2="X" l="ENG"><s0>Treatment</s0><s5>10</s5></fC03><fC03 i1="08" i2="X" l="SPA"><s0>Tratamiento</s0><s5>10</s5></fC03><fC03 i1="09" i2="X" l="FRE"><s0>Complication</s0><s5>11</s5></fC03><fC03 i1="09" i2="X" l="ENG"><s0>Complication</s0><s5>11</s5></fC03><fC03 i1="09" i2="X" l="SPA"><s0>Complicación</s0><s5>11</s5></fC03><fC03 i1="10" i2="X" l="FRE"><s0>Homme</s0><s5>12</s5></fC03><fC03 i1="10" i2="X" l="ENG"><s0>Human</s0><s5>12</s5></fC03><fC03 i1="10" i2="X" l="SPA"><s0>Hombre</s0><s5>12</s5></fC03><fC07 i1="01" i2="X" l="FRE"><s0>Hémopathie maligne</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="ENG"><s0>Malignant hemopathy</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="SPA"><s0>Hemopatía maligna</s0><s5>37</s5></fC07><fC07 i1="02" i2="X" l="FRE"><s0>Lymphoprolifératif syndrome</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="ENG"><s0>Lymphoproliferative syndrome</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="SPA"><s0>Linfoproliferativo síndrome</s0><s5>38</s5></fC07><fC07 i1="03" i2="X" l="FRE"><s0>Lymphome non hodgkinien</s0><s5>39</s5></fC07><fC07 i1="03" i2="X" l="ENG"><s0>Non Hodgkin lymphoma</s0><s5>39</s5></fC07><fC07 i1="03" i2="X" l="SPA"><s0>Linfoma no Hodgkin</s0><s5>39</s5></fC07><fC07 i1="04" i2="X" l="FRE"><s0>Radiothérapie</s0><s5>53</s5></fC07><fC07 i1="04" i2="X" l="ENG"><s0>Radiotherapy</s0><s5>53</s5></fC07><fC07 i1="04" i2="X" l="SPA"><s0>Radioterapia</s0><s5>53</s5></fC07><fN21><s1>273</s1></fN21><fN82><s1>PSI</s1></fN82></pA></standard></inist></record>Pour manipuler ce document sous Unix (Dilib)
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