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According to a recent article published in the Journal of Clinical Oncology, Zevalin™ is effective treatment for patients with recurrent follicular 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 very specific function in aiding 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. While NHL is categorized by the type of lymphocyte it involves, it is also further defined by the rate at which the cancer grows, based on the appearance of the cells under a microscope. High-grade or aggressive NHL is the fastest growing and low-grade or indolent lymphoma is the slowest growing. Follicular lymphoma is considered an indolent lymphoma.

Zevalin™ (90Yttrium-2b8 ibritumomab tiuxetan) is a biological agent that is approved for treatment of recurrent or refractory indolent B-cell NHL. Zevalin™ is a type of treatment that uses two separate strategies to target and kill cancer cells. It is comprised of ibritumomab, which is a monoclonal antibody that is attached to a radioactive substance called Yttrium 90 (90Y). The monoclonal antibody portion of Zevalin™ binds to proteins (CD 20 antigen) found only on the surface of B-cells. Once Zevalin™ binds to the cancer cells, the immune system is stimulated to attack the cancer cells, while the attached 90Y destroys these cells by spontaneous emission of its radiation. Researchers speculate that Zevalin™ may produce anti-cancer effects through additional mechanisms not fully understood at present. This type of treatment not only provides anti-cancer treatment through separate strategies, but also allows the delivery of greater amounts of radiation to the cancer cells compared with external radiation therapy, while minimizing radiation exposure to normal cells. Treatment with Zevalin™ includes administration of Rituxan® prior to administration of Zevalin™, even in patients who have stopped responding to therapy with Rituxan® alone. Rituxan® is a monoclonal antibody that also binds to B-cells and is currently approved for the treatment of low-grade B-cell NHL.

A recent multi-institutional clinical trial was recently conducted to evaluate Zevalin™ in the treatment of advanced, recurrent follicular lymphoma. This trial involved 57 patients who had received extensive prior treatment, including Rituxan® and had stopped responding to therapy. Patients first received two weekly doses of Rituxan® followed by Zevalin™. A complete disappearance of detectable cancer was achieved in 15% of patients, with an additional 59% achieving a partial disappearance of cancer. The average time to cancer progression for patients responding to treatment was almost 9 months. Treatment was generally well tolerated.

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These researchers concluded that treatment with Zevalin™ appears to be an effective treatment option for patients with follicular lymphoma who have stopped responding to standard therapies. Patients with follicular lymphoma may wish to speak with their physician about the risks and benefits of participating in a clinical trial further evaluating Zevalin™ or other promising therapies. Two sources of information regarding ongoing clinical trials include the National Cancer Institute ( and also provides personalized clinical trial searches on behalf of patients.

Reference: Witzig T, Flinn I, Gordon L, et al. Treatment with ibritumomab tiuxetan radioimmunotherapy in patients with rituximab-refractory follicular non-Hodgkin’s lymphoma.

Journal of Clinical Oncology. 2002;20:3262-3269.

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