Standard-dose Zevalin® (ibritumomab tiuxetan) combined with BEAM high-dose chemotherapy is safe and possibly more effective than BEAM therapy alone as a conditioning regimen for autologous stem cell transplantation (ASCT), according to the results of a study published in Cancer.
High-dose chemotherapy plus autologous stem cell transplantation (ASCT) is standard therapy for refractory/relapsed aggressive lymphoma; however, in the era of frontline regimens that contain Rituxan® (rituxamab), it is becoming more challenging to salvage patients in this setting.
Zevalin is a type of radioimmunotherapy treatment (RIT) that combines the monoclonal antibody Rituxan with Zevalin, which is comprised of an anti-CD20 monoclonal antibody and Yttrium-90, a radioisotope that delivers the radiation. 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.
To evaluate the safety and efficacy of standard-dose Zevalin combined with high-dose BEAM chemotherapy (Z-BEAM) prior to ASCT, researchers conducted a study that included 43 patients with CD20-positive aggressive lymphoma. Patients were randomized to receive Z-BEAM or BEAM alone.
The results indicated that overall—for all patients—the progression-free survival (PFS) was 48 percent. More specifically, PFS was 59 percent for the Z-BEAM group and 37 percent for the BEAM group. Intermediate-risk patients with one or two risk factors had better PFS with Z-BEAM (69 percent) compared with BEAM (29 percent). Two-year overall survival was 91 percent after Z-BEAM and 62 percent after BEAM.
The researchers concluded that standard-dose Zevalin combined with BEAM high-dose chemotherapy is safe and possibly more effective than BEAM alone as a conditioning regimen for ASCT.
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Shimoni A, Avivi I, Rowe JM, et al. A randomized study comparing yttrium-90 ibritumomab tiuxetan (Zevalin) and high-dose BEAM chemotherapy versus BEAM alone as the conditioning regimen before autologous stem cell transplantation in patients with aggressive lymphoma. Cancer. 2012; 118(19): 4706-4714.
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