钇-90- ibritumumab tiuxetan放射免疫治疗:b细胞非霍奇金淋巴瘤的新治疗方法。

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钇-90- ibritumumab tiuxetan放射免疫治疗:b细胞非霍奇金淋巴瘤的新治疗方法。

今日毒品(Barc)。2004年2月,40(2):111 - 9。

PubMed ID

15045033 (PubMed视图

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摘要

本文将综述ibritumomab tiuxetan(一种钇-90偶联CD20单克隆抗体)治疗复发b细胞非霍奇金淋巴瘤的临床进展。Ibritumomab是小鼠亲本抗cd20抗体，被设计用于制造人嵌合抗体利妥昔单抗。Tiuxetan是一种MX-DTPA螯合剂，与ibritumomab连接形成ibritumomab Tiuxetan。由于钇-90 ((90)Y)是纯β发射体，不能用于患者成像，铟-111 ((111)In)与ibritumomab tiuxetan螯合用于临床实践中的肿瘤和正常器官成像以及临床试验中的剂量测定。Y-ibritumomab tiuxetan是用于治疗的形式。本文综述了ibritumomab tiuxetan在复发b细胞非霍奇金淋巴瘤患者中的疗效，并总结了其安全性数据。进行了两项I期试验(90)Y-ibritumomab tiuxetan，以确定可以在不使用干细胞或预防性生长因子的情况下给予门诊患者的毒性特征和最大单次耐受剂量。在第一次试验中，在ibritumomab tixetan之前使用了冷ibritumomab;第二项试验使用人嵌合抗体利妥昔单抗。I期试验确定，对于血小板计数大于或等于150 x 10(9)/l的患者，第1天和第8天静脉注射利妥昔单抗250 mg/m(2)，第8天静脉注射Y-ibritumomab tiuxetan 0.4 mCi/ kg是安全有效的，并且不需要干细胞。 A dose of 0.3 mCi/kg was recommended for patients with a baseline platelet count of 100,000- 149,000 x 10(6)/l. Adverse events were primarily hematologic, and nonhematologic adverse events were primarily due to rituximab. There was no normal organ toxicity. The overall response rate was 67% for all patients and 82% in patients with low-grade non-Hodgkin's lymphomas. A subsequent phase III trial randomized 143 eligible patients to either rituximab or ibritumomab tiuxetan. The aim was to demonstrate that the addition of the yttrium-90 radioisotope to the antibody provided additional efficacy over the unconjugated ("cold") rituximab alone. The results of this study showed an overall response rate of 80% with (90)Y-ibritumomab tiuxetan versus 56% for rituximab (p = 0.002). An additional trial enrolled 54 patients who were nonresponsive or refractory to rituximab and treated the patients with a single dose of 0.4 mCi/kg (90)Y-ibritumomab tiuxetan. An overall response rate of 74% was found in these rituximab-refractory patients. These data provide further evidence of the added value of the yttrium-90. Finally, a fifth trial treated 30 patients with mild thrombocytopenia using 0.3 mCi/kg (90)Y-ibritumomab tiuxetan and found an overall response rate of 83%. (90)Y-ibritumomab tiuxetan radioimmunotherapy is a new treatment modality for patients with relapsed B-cell non-Hodgkin's lymphoma. The advantages of this therapy are that it utilizes targeted radiation in a single-dose, outpatient schedule that is well tolerated and accepted by the patient. Future trials will build on these results and determine at what point in the disease course this modality can best be utilized to maximize the benefits to the patient.

引用本文的药物库数据

药物靶点

药物	目标	种类	生物	药理作用	行动
Ibritumomab tiuxetan	b淋巴细胞抗原CD20	蛋白质	人类	是的	抗体 监管机构	细节