A Systematic Review of Clinical Applications of Anti-CD20 Radioimmunotherapy for Lymphoma

Author:

Durando Michael12,Gopal Ajay K34,Tuscano Joseph5,Persky Daniel16

Affiliation:

1. Division of Hematology and Oncology, University of Arizona School of Medicine , Tucson, AZ , USA

2. Fargo VA Health Care System , Fargo, ND , USA

3. Department of Internal Medicine, Division of Hematology and Oncolog, University of Washington School of Medicine , Seattle, WA , USA

4. Fred Hutchinson Cancer Research Center , Seattle, WA , USA

5. Division of Malignant Hematology/Cellular Therapy and Transplantation, University of California Davis School of Medicine , Sacramento, CA , USA

6. University of Arizona Cancer Center , Tucson, AZ , USA

Abstract

Abstract Purpose The clinical efficacy of anti-CD20 radioimmunotherapy (RIT) is due to a combination of extracellular mechanisms involving immune-mediated cytotoxicity, and intracellular mechanisms related to inhibition of CD20 signaling and DNA damage from ionizing radiation. In 2002, the first RIT was approved by the U.S. Food and Drug Administration for the treatment of patients with indolent B-cell follicular non-Hodgkin lymphoma (NHL). The 2 approved agents, 90 Y-ibritumomab tiuxetan (90Y-IT, Zevalin, Acrotech Biopharma) and 131 I-tositumomab (131-IT, Bexxar, GlaxoSmithKline) both target CD20. The aim of this study was to review the clinical applications and supporting clinical trial data of anti-CD20 RIT for lymphoma. Methods A review of published articles and abstracts on the clinical efficacy and safety of 90Y-IT and iodine I 131 tositumomab was performed. Results The clinical efficacy and safety of anti-CD20 RIT have been demonstrated in numerous clinical trials and case series. Agents have produced significant responses in patients with follicular NHLs and in off-label applications. Importantly, RIT has demonstrated promising findings in high-risk lymphomas and heavily pretreated and refractory patient populations. Associated toxicity profiles are noted as tolerable, acceptable, and most often reversible. Conclusions In the 2 decades since its approval, anti-CD20 RIT continues to demonstrate efficacy, particularly with a proportion of patients maintaining long-term remissions. The combination of prolonged efficacy, tolerability, and treatment convenience makes RIT a reasonable alternative to other systemic therapies. It is recommended that further research on RIT should focus on biomarkers of long-term response, pretargeting, and sequencing of RIT in the treatment course.

Funder

Acrotech Biopharma Inc

Publisher

Oxford University Press (OUP)

Reference51 articles.

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2. Epitope interactions of monoclonal antibodies targeting CD20 and their relationship to functional properties;Klein,2013

3. Antibody structure and function: the basis for engineering therapeutics;Chiu,2019

4. Nanotechnologies for early diagnosis, in situ disease monitoring, and prevention;Wu,2018

5. Phase III trial of consolidation therapy with yttrium-90-ibritumomab tiuxetan compared with no additional therapy after first remission in advanced follicular lymphoma;Morschhauser,2008

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