Bexxar®:: Novel radioimmunotherapy for the treatment of low-grade and transformed low-grade non-Hodgkin's lymphoma
Bexxar®:: Novel radioimmunotherapy for the treatment of low-grade and transformed low-grade non-Hodgkin's lymphoma
复制标题
DOI：
10.1634/theoncologist.9-2-160
复制
发表时间：
2004-01-01
期刊：
影响因子：
5.8
通讯作者：
Vose, JM
中科院分区：
文献类型：
--
作者：
Vose, JM
目的.使用单克隆抗体特异性靶向B细胞的免疫治疗为许多惰性淋巴瘤患者，特别是那些化疗难治性疾病患者提供了新的希望。淋巴瘤对放射极为敏感，在过去的十年中，抗CD 20抗体的放射免疫疗法的发展取得了重大进展。在此，我们回顾了托西莫单抗和碘1131托西莫单抗（Bexxar（（R））; Corixa Corporation; South San弗朗西斯科，CA;和GlaxoSmithKline; Philadelphia，PA）治疗非霍奇金淋巴瘤患者的临床经验。在复发性低级别和转化的低级别非霍奇金淋巴瘤患者中，与未结合的抗CD 20抗体相比，Bexxar治疗显示出高缓解率和长缓解持续时间。碘-131（I-131）具有悠久的临床经验历史，良好的安全记录，以及良好的核和药理学特性。重要的是，碘-131的伽马发射有助于准确的剂量测定，以计算适当的患者特异性治疗活性，从而提供预定的全身辐射剂量，从而最大限度地减少血液毒性。在Bexxar的临床试验中，在大量预治疗的患者中，客观缓解率范围为54%-71%。在关键性试验中，Bexxar治疗后缓解持续时间较长的患者数量显著大于末次合格化疗方案后缓解持续时间较长的患者数量。76例初治患者客观缓解率为97%，完全缓解率为63%。这些数据表明，Bexxar将成为治疗惰性淋巴瘤的重要新选择。
Purpose. Immunotherapy using monoclonal antibodies to specifically target B cells has provided new hope to many patients with indolent lymphomas, particularly those with chemotherapy-refractory disease. Lymphomas are extremely sensitive to radiation, and significant progress has been made over the last decade in the development of radioimmunotherapy with anti-CD20 antibodies.Materials and Methods. Herein we review clinical experience with tositumomab and iodine 1 131 tositumomab (Bexxar((R)); Corixa Corporation; South San Francisco, CA; and GlaxoSmithKline; Philadelphia, PA) in patients with non-Hodgkin's lymphoma.Results. Therapy with Bexxar has demonstrated high response rates and long durations of response compared with unconjugated anti-CD20 antibodies in patients with relapsed low-grade and transformed low-grade non-Hodgkin's lymphomas. Iodine-131 (I-131) has a long history of clinical experience, an excellent safety record, and favorable nuclear and pharmacologic properties. Importantly, the gamma emissions of iodine-131 facilitate accurate dosimetry to calculate the appropriate patient-specific therapeutic activity to deliver a predetermined total-body dose of radiation, thereby minimizing hematologic toxicity. In clinical trials of Bexxar, objective response rates ranged from 54%-71% in heavily pretreated patients. In the pivotal trial, the number of patients with a longer duration of response after treatment with Bexxar was significantly greater than the number of patients with a longer duration of response after their last qualifying chemotherapy regimen. In 76 newly diagnosed patients, the objective response rate was 97%, and 63% of patients achieved complete responses.Conclusion. These data suggest that Bexxar will become an important new option in the treatment of indolent lymphoma.