Kang Hye J, Lee Seung S, Kim Kyeong M, Choi Tae H, Cheon Gi J, Kim Won S, Suh Cheolwon, Yang Sung H, Lim Sang M
Division of Hematology/Oncology, Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Republic of Korea.
Asia Pac J Clin Oncol. 2011 Jun;7(2):136-45. doi: 10.1111/j.1743-7563.2011.01393.x.
To evaluate the efficacy and safety of radioimmunotherapy (RIT) with radioiodinated human/murine chimeric anti-CD20 monoclonal antibody rituximab ((131)I-rituximab) for treating Korean patients with relapsed or refractory B-cell non-Hodgkin's lymphomas (NHL).
All patients received unlabeled rituximab 70 mg immediately prior to the administration of a therapeutic dose (median dose: 7.3 GBq) of (131)I-rituximab. The tumor response was evaluated 1 month later by contrast enhanced (18) F-fludeoxyglucose positron emission tomography-computed tomography.
Between May 2004 and October 2006, 24 patients received single treatment with (131)I-rituximab. The overall response rate (ORR) was 29%; 46% (three complete responses, two partial responses (PR) for patients with low grade B-cell NHL (LGL) and 9% (one PR) for patients with diffuse large B-cell lymphoma (DLBCL). After a median follow-up of 55 months, the median progression-free survival (PFS) for all the patients was 2.2 months. The median overall survival (OS) was 11.3 months. There were statistically significant differences between the LGL and the DLBCL for the median PFS (4.5 months vs 1.3 months, respectively, P = 0.0007) and the median OS (30.3 months vs 6.5 months, respectively, P = 0.0295). Grades 3-4 thrombocytopenia and neutropenia occurred in 33% (8/24) and 21% (5/24) of the patients, respectively.
RIT with (131)I-rituximab seems to be effective and tolerable for patients with refractory LGL, although this treatment had modest activity in patients with refractory DLBCL. Further studies are warranted to determine the efficacy of (131)I-rituximab for treating the patients with DLBCL.
评估放射性碘化人/鼠嵌合抗CD20单克隆抗体利妥昔单抗((131)I-利妥昔单抗)放射免疫疗法(RIT)治疗韩国复发或难治性B细胞非霍奇金淋巴瘤(NHL)患者的疗效和安全性。
所有患者在给予治疗剂量(中位剂量:7.3 GBq)的(131)I-利妥昔单抗之前立即接受70 mg未标记的利妥昔单抗。1个月后通过增强(18)F-氟脱氧葡萄糖正电子发射断层扫描-计算机断层扫描评估肿瘤反应。
2004年5月至2006年10月期间,24例患者接受了(131)I-利妥昔单抗单一治疗。总缓解率(ORR)为29%;低级B细胞NHL(LGL)患者的完全缓解率为46%(3例完全缓解,2例部分缓解(PR)),弥漫性大B细胞淋巴瘤(DLBCL)患者的部分缓解率为9%(1例PR)。中位随访55个月后,所有患者的中位无进展生存期(PFS)为2.2个月。中位总生存期(OS)为11.3个月。LGL和DLBCL之间的中位PFS(分别为4.5个月和1.3个月,P = 0.0007)和中位OS(分别为30.3个月和6.5个月,P = 0.0295)存在统计学显著差异。3-4级血小板减少症和中性粒细胞减少症分别发生在33%(8/24)和21%(5/24)的患者中。
(131)I-利妥昔单抗放射免疫疗法对难治性LGL患者似乎有效且耐受性良好,尽管该治疗对难治性DLBCL患者的活性有限。有必要进一步研究以确定(131)I-利妥昔单抗治疗DLBCL患者的疗效。