Meredith Ruby F, Knox Susan J
Department of Radiation Oncology, University of Alabama Medical Center, Birmingham, AL, USA.
Int J Radiat Oncol Biol Phys. 2006;66(2 Suppl):S15-22. doi: 10.1016/j.ijrobp.2006.04.059.
Over the past several decades, several biomolecules have been investigated for their ability to deliver radiation to cancer cells, but antibodies have been the carriers of choice in systemic targeted radionuclide therapy (STaRT). Two radioimmunotherapy agents that target the CD20 antigen, (131)I-tositumomab and (90)Y-ibritumomab tiuxetan, have been approved by the U.S. Food and Drug Administration for the treatment of patients with relapsed or refractory B-cell non-Hodgkin's lymphoma (NHL), and clinical trials have shown that they are effective as monotherapies in the salvage setting, producing response rates that are often higher and durations of response that are often longer than those with chemotherapy. Escalated doses of these agents can be supported with stem cell transplantation and can produce high rates of complete response and greater survival in patients with relapsed NHL. The quality and duration of responses are greater with radioimmunotherapy when it is used earlier in the course of treatment.
在过去几十年里,人们研究了多种生物分子将辐射传递至癌细胞的能力,但在全身靶向放射性核素治疗(STaRT)中,抗体一直是首选载体。两种靶向CD20抗原的放射免疫治疗药物,即(131)I-托西莫单抗和(90)Y-伊布替莫单抗替曲膦,已获美国食品药品监督管理局批准用于治疗复发或难治性B细胞非霍奇金淋巴瘤(NHL)患者,临床试验表明,它们作为挽救治疗的单一疗法有效,产生的缓解率通常高于化疗,缓解持续时间通常也长于化疗。这些药物剂量的增加可通过干细胞移植来支持,并且可使复发NHL患者产生高完全缓解率和更高生存率。放射免疫治疗在治疗过程中更早使用时,缓解的质量和持续时间更佳。