Iodine-131 tositumomab (Bexxar): radioimmunoconjugate therapy for indolent and transformed B-cell non-Hodgkin's lymphoma.
Iodine-131 tositumomab (Bexxar): radioimmunoconjugate therapy for indolent and transformed B-cell non-Hodgkin's lymphoma.
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DOI：
10.1586/14737140.4.1.18
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发表时间：
2004-02-01
影响因子：
3.3
通讯作者：
Fisher, Richard I
中科院分区：
文献类型：
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作者：
Friedberg, Jonathan W;Fisher, Richard I
托西莫单抗是一种免疫球蛋白 G 鼠单克隆抗体，可与正常和恶性人类 B 细胞表面的 CD20 抗原结合。托西莫单抗与碘 131 共价连接，产生放射免疫缀合物碘 131 托西莫单抗 (Bexxar)。碘-131托西莫单抗方案于2003年6月获得美国食品和药物管理局批准，用于治疗CD20阳性滤泡性非霍奇金淋巴瘤患者，无论是否发生转化，其疾病对利妥昔单抗（Rituxan）耐药且化疗后复发。碘 131 托西莫单抗的剂量限制性毒性是骨髓抑制并导致血细胞减少。与化疗不同，与碘 131 托西莫单抗相关的大多数非血液学不良事件本质上是轻度至中度，并且通常是自限性的。 Iodine-131 托西莫单抗是治疗复发性惰性和转化 B 细胞非霍奇金淋巴瘤最有效的单药之一，本综述中总结的几项临床试验证明了这一点。目前，放射免疫结合疗法的使用主要限于患有利妥昔单抗治疗难治性疾病和不适合高剂量治疗和自体干细胞支持的转化疾病的患者。对正在进行的临床试验进行更长时间的随访应该可以保证安全性，并深入了解碘 131 托西莫单抗给药所带来的附加干细胞毒性。研究还探讨了碘 131 托西莫单抗作为惰性非霍奇金淋巴瘤初始治疗和非霍奇金淋巴瘤其他组织学组成部分的作用。
Tositumomab is an immunoglobulin G murine monoclonal antibody that binds to the CD20 antigen on the surface of normal and malignant human B-cells. Tositumomab is linked covalently with iodine-131 to produce the radioimmunoconjugate iodine-131 tositumomab (Bexxar). The iodine-131 tositumomab regimen was approved by the US Food and Drug Administration in June 2003 for the treatment of patients with CD20-positive, follicular non-Hodgkin's lymphoma, both with and without transformation, whose disease is refractory to rituximab (Rituxan) and has relapsed following chemotherapy. The dose-limiting toxicity of iodine-131 tositumomab is bone marrow suppression and resulting cytopenias. Unlike chemotherapy, the majority of nonhematologic adverse events associated with iodine-131 tositumomab are mild to moderate in nature and usually self limited. Iodine-131 tositumomab represents one of the most active single agents for the treatment of recurrent indolent and transformed B-cell non-Hodgkin's lymphoma, as demonstrated by several clinical trials summarized in this review. At the present time, the use of radioimmunoconjugate therapy is largely limited to patients with disease refractory to rituximab therapy and transformed disease not amenable to high-dose therapy and autologous stem cell support. Longer follow-up of ongoing clinical trials should provide reassurance as to safety and insights as to the additive stem cell toxicity from iodine-131 tositumomab administration. Studies are also addressing the role of iodine-131 tositumomab as a component of initial therapy for indolent non-Hodgkin's lymphoma and in additional histologies of non-Hodgkin's lymphoma.