90 Y-ibritumomab tiuxetan: a nearly forgotten opportunity
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Patrizia Mondello1,2,3, Salvatore Cuzzocrea2, Michele Navarra2 and Michael Mian4,5
1 Department of Human Pathology, University of Messina, Messina, Italy
2 Department of Biological and Environmental Sciences, University of Messina, Messina, Italy
3 Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
4 Department of Hematology, Hospital S. Maurizio, Bolzano/Bozen, Italy
5 Department of Internal Medicine V, Hematology and Oncology, Medical University Innsbruck, Innsbruck, Austria
Patrizia Mondello, email:
Keywords: radioimmunotherapy, Y-ibritumomab tiuxetan, follicular lymphoma, diffuse large B-cell lymphoma, mantle cell lymphoma
Received: September 11, 2015 Accepted: November 26, 2015 Published: December 09, 2015
Y-ibritumomab tiuxetan (90Y-IT) combines the benefits of a monoclonal antibody with the efficacy of radiation in the treatment of B-cell non-Hodgkin lymphoma (NHL), a remarkably radiosensitive hematologic malignancy. 90Y-IT activity has been well established in the indolent setting, being approved in front-line treatment of follicular lymphoma (FL) patients as well as salvage therapy. However, no advantage in OS was observed with respect to standard treatment. Promising data are available also for aggressive B-cell lymphoma. In particular, the addition of RIT to short-course first line chemotherapy enables reduction of chemotherapy while maintaining cure rates in elderly, untreated diffuse large B-cell lymphoma (DLBCL) patients. Furthermore, 90Y-IT improves response rate and outcomes of relapsed/refractory DLBCL patients, eligible and ineligible for autologous stem cell transplantation (ASCT). Clinical results have shown a role of 90Y-IT even in mantle cell lymphoma (MCL). RIT might improve responses and treat minimal residual disease when used as consolidation after first-line chemotherapy in MCL. Moreover, 90Y-IT has demonstrated its efficacy in combination with high-dose chemotherapies as conditioning regimen for ASCT, with evidence suggesting the ability to overcome chemotherapy resistance. Herein, we review the available evidence for this approved drug and examine the recently published and ongoing trials for potential novel indication in aggressive B-cell NHL.
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