March 8, 2009

Zevalin® Effective for Treatment of Cutaneous B-Cell Lymphoma


Zevalin® Effective for Treatment of Cutaneous B-Cell Lymphoma

Zevalin® (Yttrium-90 [(90)Y] ibritumomab tiuxetan) appears highly effective in the treatment of primary cutaneous B-cell lymphoma (PCBCL). The details of this study appeared in an early online publication in Leukemia-Lymphoma on July 25, 2008.

Non-Hodgkin’s lymphoma (NHL) is a form of cancer that begins in the cells of the lymph system. The lymph system includes the spleen, thymus, tonsils, bone marrow, lymph nodes, and circulating immune cells. The main cells in the lymph system are lymphocytes, of which there are two types: B and T-cells. Each of these cells has a specific function in helping the body to fight infection.

NHL is characterized by the excessive accumulation of atypical (cancerous) lymphocytes. These lymphocytes can crowd the lymph system and suppress the formation and function of other immune and blood cells. NHL is categorized by the type of lymphocyte it involves and by the rate at which the cancer grows. PCBCL is a type of NHL in which the immune cells of the skin are affected, creating “lesions,” or sores on the skin.

Standard therapies for PCBCL typically include chemotherapy and/or radiation therapy. However, researchers continue to evaluate novel therapeutic approaches that are both effective and reduce side effects.

Radioimmunotherapy is an approach that involves treatment with a radioactive substance linked to an antibody. The antibody attaches to cancer cells when injected into the body. By delivering the radiation directly to the cancer, a larger amount of normal tissue is spared from radiation and there are fewer side effects. Zevalin, a radioimmunotherapeutic agent, contains a monoclonal antibody portion that attaches to a protein (CD20) found only on the surface of B-lymphocytes, such as on cancerous B-cells found in many forms of NHL. The radioactivity that is spontaneously emitted targets the B-cell and destroys it.

Results from several clinical trials have demonstrated Zevalin’s effectiveness in the treatment of NHL. However, physicians must refer patients to radiologists or a nuclear medicine specialist for treatment with Zevalin. There is speculation that the referral process may contribute to low use of Zevalin among patients who might derive great benefit from its effects.

Researchers from Germany recently conducted a small clinical trial including 10 patients with PCBCL. All patients were treated with Zevalin.

  • 100% of patients achieved a complete disappearance of all detectable cancer (complete remission).
  • The median time to cancer progression was one year.
  • 40% of patients remain in complete remission at a median follow-up of 19 months.

The researchers concluded that these data provide further evidence that Zevalin appears extremely effective in several types of NHL, including PCBCL. Patients with PCBCL may wish to speak with their physician regarding their individual risks and benefits of treatment with Zevalin.

Reference: Mazza S, Gellrich S, Assaf C, et al. Yttrium-90 ibritumomab tiuxetan radioimmunotherapy in primary cutaneous B-cell lymphomas: first results of a prospective, monocentre study. Leukemia-Lymphoma [early online publication]. July 25, 2008.

Related News: Zevalin® Significantly Improves Progression-free Survival in Follicular NHL (12/13/2007)

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