Bestraling - Radiotherapie bij non-Hodgkin lymfoom en gelabeld met monoklonale antibodies geeft significant langere tijd van overleven, ook als eerdere behandelingen faalden.

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11 januari 2012:
Interessant is aanvullend op onderstaande informatie uit 2010 te vermelden een overzichts artikel van de aanpak met radiotherapie - bestraling in combinatie met vormen van chemo en immuuntherapeutische middelen waaronder ook Zevalin en Bexxar en Yttrium-90: Radioimmunotherapy of Non-Hodgkin’s Lymphoma: From the ‘Magic Bullets’ to ‘Radioactive Magic Bullets’
In het abstract staat dit, maar klikt u op deze link voor het volledige studierapport. Onderaan staat informatie over radio immuuntherapie uit 2010:

Source: Radioimmunotherapy (RIT) of lymphoma with Zevalin and Bexxar was approved by FDA in 2002 and 2003, respectively, for the treatment of relapsed or refractory CD20+ follicular B-cell non-Hodgkin´s lymphoma. In 2009, Zevalin was also approved for consolidation therapy in patients with follicular non-Hodgkin’s lymphoma that achieve a partial or complete response to first-line chemotherapy. For follicular lymphoma patients, the overall response and progression-free survival rates have significantly improved since the implementation of RIT. The predominant complication of RIT is hematological toxicity that is usually manageable. There are ongoing trials to further define the expanding role of RIT as first line or concomitant therapy in the treatment of lymphoma as well as for certain antibiotic resistant infections and aggressive malignancies. There is also growing interest in the development of newer protocols for increased and more uniform dose delivery resulting in better outcomes and improved patient survival. This review will primarily focus on the role of RIT in treatment of non-Hodgkin’s lymphoma, which is of established clinical utility and FDA approved. The mechanism of RIT, available radionuclides and pharmacokinetics, therapy administration, clinical utility and toxicities, and future directions would be discussed.

27 maart 2007: Bron: 1: Cancer. 2007 Mar 22;

Wanneer patiënten die een herhaaldelijk recidief hebben gekregen van non-Hodgkin lymfomen (B-cell) en waarbij o.a. eerdere behandelingen niet meer werkten (bij 37% van de deelnemende patiënten) een extra behandeling krijgen met radio-immuuntherapie, bestraling met daarbij gelabeld monoklonale antibodies, blijkt hun levensduur mediaan aanzienlijk toe te nemen. De mediane tijd tot een recidief of progressie van de ziekte bleek te komen op 29 maanden. De vijfjaars overleving ging naar 53% voor deze groep van patiënten.

Long-term responses in patients with recurring or refractory B-cell non-Hodgkin lymphoma treated with yttrium 90 ibritumomab tiuxetan.
Witzig TE, Molina A, Gordon LI, Emmanouilides C, Schilder RJ, Flinn IW, Darif M, Macklis R, Vo K, Wiseman GA.
Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, Minnesota.

BACKGROUND.: Radioimmunotherapy with radiolabeled monoclonal antibodies to CD20 produces a high response rate in patients with recurring non-Hodgkin lymphoma (NHL), but the durability of those remissions is not well defined.

METHODS.: Data on patients with recurring NHL treated with yttrium Y 90 ibritumomab tiuxetan in 4 clinical trials were reviewed to identify patients with a long-term response, defined as a time to progression of 12 months or longer.

RESULTS.: Long-term responses were seen in 37% (78/211) of patients. At a median follow-up of 53.5 months (range, 12.7-88.9) the median duration of response was 28.1 months and the median time to progression was 29.3 months. A third of these patients had been treated with at least 3 previous therapies, and 37% of them had not responded to their last therapy. The findings in patients with follicular lymphoma (n = 59) were similar to those in the overall population of long-term responders. The estimated overall survival at 5 years was 53% for all patients treated with (90)Y ibritumomab tiuxetan and 81% for long-term responders.

CONCLUSIONS.: A single dose of (90)Y ibritumomab tiuxetan can produce durable responses and prolonged overall survival in a substantial number of patients in whom previous therapies have failed. Cancer 2007. (c) 2007 American Cancer Society. PMID: 17380530 [PubMed - as supplied by publisher]

bestraling, lymfklierkanker, radiotherapie