We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Yttrium-90-Ibritumomab Tiuxetan (Zevalin®) Radioimmunotherapy after Cytoreduction with ESHAP Chemotherapy in Patients with Relapsed Follicular Non-Hodgkin Lymphoma: Final Results of a Phase II Study.
- Authors
Puvvada, Soham D.; Guillén-Rodríguez, José M.; Yan, Jessica; Inclán, Lora; Heard, Kara; Rivera, Xavier I.; Anwer, Faiz; Mahadevan, Daruka; Schatz, Jonathan H.; Persky, Daniel O.
- Abstract
<bold><italic>Background:</italic></bold> Radioimmunotherapy (RIT) is effective in treating relapsed/refractory follicular lymphoma (FL), with durable remissions in first-line consolidation. We hypothesized that RIT with ibritumomab tiuxetan (Zevalin®) would result in durable remissions by eliminating minimal residual disease after cytoreduction. <bold><italic>Methods:</italic></bold> Patients with FL received 2 cycles of ESHAP (etoposide, methylprednisolone, cytarabine, cisplatin) every 28 days, followed by Zevalin 4–6 weeks later if there was no disease progression and bone marrow biopsy showed < 25% involvement. <bold><italic>Results:</italic></bold> Twenty-eight patients were treated, with a median age of 61 years, median of 3 prior therapies, 49% high-risk disease (Follicular Lymphoma International Prognostic Index, FLIPI), and 39% progressive disease. Three patients did not receive Zevalin due to residual bone marrow involvement. The main toxicities were cytopenias, with 11% febrile neutropenia. The overall response rate (ORR) was 72%, with 45% achieving complete response. With a median follow-up of 73 months, 1-year progression-free survival (PFS) was 38%, and median PFS was 10 months, but median overall survival (OS) was not reached. <bold><italic>Conclusion:</italic></bold> The study did not reach its primary endpoint of a 1-year PFS of 67.3%. Reasons for this could include low accrual, high-risk disease, and inadequate debulking provided by 2 cycles of ESHAP. However, this protocol was associated with tolerable toxicity, high ORR, and high OS. Further studies would optimize debulking and focus on high-risk FL patients.
- Subjects
CANCER chemotherapy; CANCER relapse; LYMPHOMAS; RADIOIMMUNOTHERAPY; SURVIVAL; RANDOMIZED controlled trials; DISEASE remission; DISEASE progression; CYTOREDUCTIVE surgery
- Publication
Oncology, 2018, Vol 94, Issue 5, p274
- ISSN
0030-2414
- Publication type
Article
- DOI
10.1159/000486788