Practical and clinical benefits of radioimmunotherapy lead to advantages in cost-effectiveness in the treatment of patients with non-Hodgkin's lymphoma

90 Y-ibritumomab-tiuxetan as a therapeutic alternative for follicular lymphoma (FL): A single-center experience

BACKGROUND

Follicular lymphoma (FL) is the most frequent indolent lymphoma subtype in adults. Maintenance therapy with rituximab is frequently applied to FL patients with complete or partial response following initial chemoimmunotherapy. However, radioimmunotherapy with ⁹⁰ Y-ibritumomab-tiuxetan represents a therapeutic alternative.

METHODS

To compare the clinical and the prognostic impact of both therapies, a study collective of n = 56 patients diagnosed with indolent B-cell lymphoma was retrospectively investigated. The study collective was subdivided into two groups: n = 36 patients treated with rituximab maintenance therapy vs n = 20 patients treated with ⁹⁰ Y-ibritumomab-tiuxetan.

RESULTS

No prognostic differences for performance status, FLIPI score, gender, or B-symptoms were found for ⁹⁰ Y-ibritumomab-tiuxetan or rituximab maintenance therapy. Overall survival rates and progression-free survival did not differ between both maintenance therapies.

CONCLUSION

Our retrospective single-center analysis of two patient groups without major differences in prognostic parameters revealed similar outcome with two different maintenance therapies. Hence, ⁹⁰ Y-ibritumomab-tiuxetan therapy might offer a valuable alternative treatment option for FL patients with partial response. However, large prospective trials are needed to confirm the reported findings.

[New clinical technologies in drug development]

The integration of functional imaging and therapeutic nuclear medicine technologies mainly in the early phases of drug development (clinical technologies implementation, CTI) is a relatively young option, which has amply influenced drug development concepts in the pharmaceutical industry. Over the past 15 years, the greatest risk reduction in drug development decision making has resulted from the earlier involvement of drug metabolism in the optimization stage of drug design rather than the late-stage characterization of target molecules. Go/no-go decisions of drug development programs and drug dosage can also be inferred from these techniques, which lead to decreases in time and costs. Not only is CTI effectively used in early drug development, but also in later clinical study phases (phases 3b/4) as a therapy monitoring or follow-up instrument. In addition, CTI is interesting and promising for the development of new therapy concepts in nuclear medicine which involve the application of monoclonal antibodies and peptides for treatment of different hematologic-oncologic diseases.