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KEY FACTS
Terminology
Procedure
Outcomes
TERMINOLOGY
Definitions
- Y-90 ibritumomab tiuxetan (Zevalin) radioimmunotherapy (RIT)
- Targeted therapy delivering localized radiation to tumor via monoclonal antibody (anti-CD20)
- Epitope CD20 often expressed on B cells of non-Hodgkin lymphoma (NHL), pre-B cells, and mature B cells, but not plasma cells
- Labeling anti-CD20 with radionuclide allows for 2 therapeutic mechanisms
- Anti-CD20 promotes cellular apoptosis and delivers radionuclide to tumor
- Emission of β particle from radionuclide provides local radiation to tumor cells
- Physical t1/2 of 2.7 days; β decay, particle energy 2.3 MeV; particle path length 5.3 mm
- Ibritumomab: Murine monoclonal antibody (anti-CD20), which binds to CD20(+) cells
- Tiuxetan: Metallic stabilizing agent used to link Y-90 and ibritumomab
- Tumor-absorbed radiation dose ~ 15 Gy (1,500 rad)
- Tumor:Normal tissue = 7:1
- Targeted therapy delivering localized radiation to tumor via monoclonal antibody (anti-CD20)
- Another RIT drug, I-131 tositumomab (Bexxar), was discontinued in 2014 for commercial reasons, partly due to projected decline in sales
- Y-90 ibritumomab tiuxetan (Zevalin) radioimmunotherapy (RIT)
PREPROCEDURE
Indications
Getting Started
Precautions
PROCEDURE
Equipment Preparation
Procedure Steps
POST PROCEDURE
Expected Outcome
Things To Do
Things To Avoid
Problems
Selected References
- Kitajima K et al: Early evaluation of tumor response to 90Y-ibritumomab radioimmunotherapy in relapsed/refractory B cell non-Hodgkin lymphoma: What is the optimal timing for FDG-PET/CT? Eur Radiol. 29(7):3935-44, 2019
- Rizzieri D: Zevalin(®) (ibritumomab tiuxetan): After more than a decade of treatment experience, what have we learned? Crit Rev Oncol Hematol. 105:5-17, 2016
- Prasad V: The withdrawal of drugs for commercial reasons: the incomplete story of tositumomab. JAMA Intern Med. 174(12):1887-8, 2014
- Chamarthy MR et al: Radioimmunotherapy of non-Hodgkin's lymphoma: from the 'magic bullets' to 'radioactive magic bullets'. Yale J Biol Med. 84(4):391-407, 2011
- Goldsmith SJ: Radioimmunotherapy of lymphoma: Bexxar and Zevalin. Semin Nucl Med. 40(2):122-35, 2010
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References
Tables
Tables
KEY FACTS
Terminology
Procedure
Outcomes
TERMINOLOGY
Definitions
- Y-90 ibritumomab tiuxetan (Zevalin) radioimmunotherapy (RIT)
- Targeted therapy delivering localized radiation to tumor via monoclonal antibody (anti-CD20)
- Epitope CD20 often expressed on B cells of non-Hodgkin lymphoma (NHL), pre-B cells, and mature B cells, but not plasma cells
- Labeling anti-CD20 with radionuclide allows for 2 therapeutic mechanisms
- Anti-CD20 promotes cellular apoptosis and delivers radionuclide to tumor
- Emission of β particle from radionuclide provides local radiation to tumor cells
- Physical t1/2 of 2.7 days; β decay, particle energy 2.3 MeV; particle path length 5.3 mm
- Ibritumomab: Murine monoclonal antibody (anti-CD20), which binds to CD20(+) cells
- Tiuxetan: Metallic stabilizing agent used to link Y-90 and ibritumomab
- Tumor-absorbed radiation dose ~ 15 Gy (1,500 rad)
- Tumor:Normal tissue = 7:1
- Targeted therapy delivering localized radiation to tumor via monoclonal antibody (anti-CD20)
- Another RIT drug, I-131 tositumomab (Bexxar), was discontinued in 2014 for commercial reasons, partly due to projected decline in sales
- Y-90 ibritumomab tiuxetan (Zevalin) radioimmunotherapy (RIT)
PREPROCEDURE
Indications
Getting Started
Precautions
PROCEDURE
Equipment Preparation
Procedure Steps
POST PROCEDURE
Expected Outcome
Things To Do
Things To Avoid
Problems
Selected References
- Kitajima K et al: Early evaluation of tumor response to 90Y-ibritumomab radioimmunotherapy in relapsed/refractory B cell non-Hodgkin lymphoma: What is the optimal timing for FDG-PET/CT? Eur Radiol. 29(7):3935-44, 2019
- Rizzieri D: Zevalin(®) (ibritumomab tiuxetan): After more than a decade of treatment experience, what have we learned? Crit Rev Oncol Hematol. 105:5-17, 2016
- Prasad V: The withdrawal of drugs for commercial reasons: the incomplete story of tositumomab. JAMA Intern Med. 174(12):1887-8, 2014
- Chamarthy MR et al: Radioimmunotherapy of non-Hodgkin's lymphoma: from the 'magic bullets' to 'radioactive magic bullets'. Yale J Biol Med. 84(4):391-407, 2011
- Goldsmith SJ: Radioimmunotherapy of lymphoma: Bexxar and Zevalin. Semin Nucl Med. 40(2):122-35, 2010
