According to results recently presented at the 2007 annual meeting of the American Society of Hematology, addition of Zevalin® (Y-ibritumomab tiuxetan) following initial therapy prolongs progression-free survival by two years among patients with follicular non-Hodgkin’s 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. 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 specific function in helping 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. NHL is categorized by the type of lymphocyte it involves and by the rate at which the cancer grows. Follicular lymphoma tends to be slow-growing and is referred to as an indolent type of NHL. It is the most common type of NHL.
In an attempt to avoid the often debilitating side effects associated with chemotherapy and radiation-standard treatment for NHL-researchers have been investigating novel therapeutic strategies for NHL.
Radioimmunotherapy is a novel therapy that involves treatment with a radioactive substance linked to an antibody. The antibody attaches to cancer cells when injected into the body. By delivering the radiation directly to the cancer, a larger amount of normal tissue is spared from radiation and there are fewer side effects. Zevalin, a radioimmunotherapeutic agent, is an antibody with radioactive Yttrium 90 attached. The monoclonal antibody portion of the drug attaches to a protein (CD20) found only on the surface of B-lymphocytes, such as cancerous B-cells found in many forms of NHL. The radioactivity that is spontaneously emitted targets the B-cell and destroys it.
Results from several clinical trials have demonstrated Zevalin’s effectiveness in the treatment of NHL. However, physicians must refer patients to radiologists or a nuclear medicine specialist for treatment with Zevalin. There is speculation that the referral process may contribute to low use of Zevalin among patients who might derive great benefit from its effects.
Researchers from 13 different countries recently conducted a clinical trial to further evaluate Zevalin in the treatment of follicular NHL. This trial included 414 patients with advanced follicular NHL who were treated with standard chemotherapy. Patients who achieved anticancer responses either received additional treatment with Zevalin or no further treatment. Follow-up was approximately three and a half years.
- Median progression-free survival was more than three years for patients treated with Zevalin compared with 13.5 months for those who did not receive Zevalin.
- Side effects associated with Zevalin included low levels of blood cells.
The researchers concluded that treatment with Zevalin following responses to chemotherapy provides two years of additional progression-free survival among patients with advanced follicular NHL.
Patients with follicular NHL may wish to speak with their physician regarding the risks and benefits of treatment with Zevalin or other radioimmunotherapeutic agents.
Reference: Hagenbeek A, et al “90Y-ibritumomab tiuxetan (Zevalin) consolidation of first remission in advanced stage follicular non-Hodgkin’s lymphoma: first results of the international randomized Phase 3 first-line indolent trial (FIT) in 414 patients. Proceedings from the 2007 annual meeting of the American Society of Hematology. Abstract 643.
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