Posted on January 10th, 2013 by
Consolidation therapy with Zevalin® (ibritumomab tiuxetan) significantly prolongs progression-free survival and leads to high conversion rates from partial response to complete response in patients with advanced follicular lymphoma, according to the results of a study published in the Journal of Clinical Oncology.
Understanding Zevalin and RIT
Zevalin therapy combines the monoclonal antibody Rituxan® (rituximab) with Zevalin, which is comprised of an anti-CD20 monoclonal antibody and Yttrium-90, a radioisotope that delivers the radiation. This is referred to as radioimmunotherapy (RIT). When injected into the body, Zevalin attaches to a protein (CD20) found only on the surface of B-lymphcytes, such as cancerous B-cells found in many forms of non-Hodgkin’s lymphoma. The radioactivity that is spontaneously emitted targets the B-cell and destroys it. This approach protects healthy tissue.
Zevalin has been shown to be a highly effective treatment-and has the added benefit of being administered over a single short period of time. Zevalin is administered on an outpatient basis and the total duration of therapy is less than 10 days. Zevalin offers active patients the opportunity to spend less time undergoing treatment than more conventional chemotherapy.
Treating Advanced Follicular Lymphoma
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. Follicular lymphoma is a type of NHL that is considered to be a low-grade or indolent lymphoma, meaning it is a slow-growing subset of NHL. It involves a type of white blood cell known as a B cell.
Follicular lymphoma is the most common form of NHL—and conventional chemotherapy is not considered curative. Individuals with advanced follicular lymphoma have a median survival time of 8 to 10 years.
Maintenance—or consolidation—therapy refers to longer-term treatment that is given after patients achieve remission with standard therapy. The goal of maintenance therapy is to prolong remission. Historically, the standard approach for treating follicular lymphoma was radiation therapy—but now a newer, more targeted option is available: RIT.
Zevalin and Advanced Follicular Lymphoma
Researchers conducted a study that included 414 patients with CD20-positive stage III or IV follicular lymphoma who achieved a complete or partial response after first-line induction treatment. Patients were randomly assigned to receive Zevalin or no further treatment
After a median follow-up of 3.5 years, the results indicated that Zevalin significantly prolonged median progression-free survival (PFS) in all patients, regardless of whether they had achieved a partial or complete response. Median PFS in patients treated with Zevalin was 36.5 months, compared to 13.3 months for patients in the control group. For patients who achieved a partial response after induction treatment, those who received Zevalin had a median PFS of 29.3 months compared to 6.2 months for those in the control group. Among patients who achieved complete response after induction, those who received Zevalin had a median PFS of 53.9 months compared to 29.5 months in the control group. What’s more—77 percent of patients who experienced a partial response after induction converted to a complete response, which resulted in a final complete response rate of 87 percent.
The researchers concluded that Zevalin significantly prolonged PFS and resulted in a high conversion rate from partial to complete response, regardless of the type of first-line induction treatment.
Morschhauser F, Radford J, Van Hoof A, et al. Phase III trial of consolidation therapy with yttrium-90-ibritumomab tiuxetan compared with no additional therapy after first remission in advanced follicular lymphoma. Journal of Clinical Oncology. 2008; 26: 5156-5164.
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