Multicenter phase II clinical study of iodine-131-rituximab radioimmunotherapy in relapsed or refractory indolent non-Hodgkin's lymphoma.

Abstract

PURPOSE:

To evaluate efficacy and safety of iodine-131 (131I) -rituximab chimeric anti-CD20 antibody radioimmunotherapy in patients with relapsed or refractory indolent non-Hodgkin's lymphoma (NHL).

PATIENTS AND METHODS:

After a standard loading dose of rituximab 375 mg/m2, individualized dosimetry was performed by whole-body gamma imaging of a tracer activity of 131I-rituximab followed by administration of a therapeutic activity of 131I-rituximab to deliver an estimated whole-body radiation absorbed dose of 0.75 Gy.

RESULTS:

Ninety-one patients were entered onto the trial: 78 patients (86%) had follicular lymphoma, six patients (7%) had mucosa-associated lymphoid tissue/marginal zone lymphoma, and seven patients (8%) had small lymphocytic lymphoma. The objective overall response rate (ORR) was 76%, with 53% attaining a complete response (CR) or CR unconfirmed (CRu). Median duration of response for patients achieving CR/CRu was 20 v 7 months for those with a partial response (P = .0121). Median progression-free survival for the entire cohort was 13 months, with 14% remaining relapse free beyond 4 years. Median follow-up was 23 months, with a 4-year actuarial survival rate of 59% +/- 10%. Toxicity was principally hematologic; grade 4 thrombocytopenia occurred in 4% and neutropenia occurred in 16% of patients, with nadirs at 6 to 7 weeks after treatment.

CONCLUSION:

131I-rituximab radioimmunotherapy of relapsed or refractory indolent NHL achieves high ORR and CR rates with minimal toxicity.

• Authors: Michael F Leahy, John F Seymour, Rodney J Hicks, J Harvey Turner
• Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology (J Clin Oncol) Vol. 24 Issue 27 Pg. 4418-25 (Sep 20 2006) ISSN: 1527-7755 [Electronic] United States
• PMID: 16940276 (Publication Type: Clinical Trial, Phase II, Journal Article, Multicenter Study)

Chemical References

• Antibodies, Monoclonal
• Antibodies, Monoclonal, Murine-Derived
• Antineoplastic Agents
• Iodine Radioisotopes
• Rituximab

Topics

• Adult
• Aged
• Aged, 80 and over
• Antibodies, Monoclonal (adverse effects, therapeutic use)
• Antibodies, Monoclonal, Murine-Derived
• Antineoplastic Agents (adverse effects, therapeutic use)
• Disease-Free Survival
• Female
• Humans
• Iodine Radioisotopes (adverse effects, therapeutic use)
• Lymphoma, B-Cell (diagnostic imaging, pathology, radiotherapy)
• Male
• Middle Aged
• Radioimmunotherapy (adverse effects, methods)
• Radiotherapy Dosage
• Rituximab
• Survival Analysis
• Tomography, Emission-Computed, Single-Photon
• Tomography, X-Ray Computed
• Treatment Outcome
• Whole-Body Irradiation