Ciência e terapia do câncer

Abdominal wall sarcomas are rare tumors with a high recurrence rate. We present the case report of a 48-yearold female patient, who was admitted for an asymmetric, voluminous tumor in the lower abdomen, which had been rapidly increasing during the previous two months. The tumor was painless and fixed to the abdominal wall. Two other sarcomas had been resected from the same place, 2 years before-the former and 7 months before-the latter. The patient underwent a surgical procedure, consisting of a wide, tumor-free margin resection, which led to the removal of the rectus abdominis muscles under the umbilicus; abdominal wall reconstruction required a prosthetic mesh. Post-operative course did not include significant issues. Adjuvant radiotherapy was indicated, in order to decrease the risk of another recurrence.

Purpose: Both anti-CD20 antibodies (ibritumomab; ZEVALIN® and tositumomab; BEXXAR®) currently used for radioimmunotherapy of B cell non-Hodgkin’s lymphoma are murine immunoglobulins. The aim of this feasibility study was to evaluate the safety and efficacy of radioimmunotherapy with a human chimeric anti-CD20 antibody labelled with Yttrium-90 (90Y-rituximab) in patients with B cell lymphoma.

Methods: Patients with CD20+ B-cell lymphoma in partial remission or with progressive disease after at least one line of therapy were included. 90Y-rituximab was administered according to a similar schedule as currently approved by the European Medicines Agency for the treatment with 90Y-ibritumomab tiuxetan (ZEVALIN®): a first infusion of rituximab 250 mg/m² is repeated one week later and directly followed by the injection of 90Y-rituximab (14,8 MBq/kg). 18FDG-PET/CT was performed before treatment and repeated 3 months after for response assessment.

Results: Twenty-six patients were treated with 90Y-rituximab. Disease histologies included mainly follicular lymphomas (53%). Toxicity was primarily haematological. The incidence of grade 3-4 neutropenia, thrombocytopenia and anemia were 34%, 38%, and 8% respectively, with spontaneous recovery in all but one patient that needed autologous stem cell transplant for refractory thrombocytopenia. Among the relevant long-term side effects, one patient developed secondary myelodysplasia 2 years after the treatment. The overall response rate was 88% (95% CI: 70%-98%), including 65% complete metabolic responses and 23% partial metabolic responses. After a median follow-up of 29.6 months, the Kaplan-Meier estimated median progression-free survival was 9, 1 months (95% CI 6,1-17,9). Median time to next treatment was 24 months (95% CI: 12, 2-28).

Conclusion: Radioimmunotherapy with 90Y-rituximab in patients with relapsed CD20+ B-cell lymphomas is safe, well tolerated and effective when the ZEVALIN® treatment schedule is used. 

Purpose: Both anti-CD20 antibodies (ibritumomab; ZEVALIN® and tositumomab; BEXXAR®) currently used for radioimmunotherapy of B cell non-Hodgkin’s lymphoma are murine immunoglobulins. The aim of this feasibility study was to evaluate the safety and efficacy of radioimmunotherapy with a human chimeric anti-CD20 antibody labelled with Yttrium-90 (90Y-rituximab) in patients with B cell lymphoma.

Methods: Patients with CD20+ B-cell lymphoma in partial remission or with progressive disease after at least one line of therapy were included. 90Y-rituximab was administered according to a similar schedule as currently approved by the European Medicines Agency for the treatment with 90Y-ibritumomab tiuxetan (ZEVALIN®): a first infusion of rituximab 250 mg/m² is repeated one week later and directly followed by the injection of 90Y-rituximab (14,8 MBq/kg). 18FDG-PET/CT was performed before treatment and repeated 3 months after for response assessment.

Results: Twenty-six patients were treated with 90Y-rituximab. Disease histologies included mainly follicular lymphomas (53%). Toxicity was primarily haematological. The incidence of grade 3-4 neutropenia, thrombocytopenia and anemia were 34%, 38%, and 8% respectively, with spontaneous recovery in all but one patient that needed autologous stem cell transplant for refractory thrombocytopenia. Among the relevant long-term side effects, one patient developed secondary myelodysplasia 2 years after the treatment. The overall response rate was 88% (95% CI: 70%-98%), including 65% complete metabolic responses and 23% partial metabolic responses. After a median follow-up of 29.6 months, the Kaplan-Meier estimated median progression-free survival was 9, 1 months (95% CI 6,1-17,9). Median time to next treatment was 24 months (95% CI: 12, 2-28).

Conclusion: Radioimmunotherapy with 90Y-rituximab in patients with relapsed CD20+ B-cell lymphomas is safe, well tolerated and effective when the ZEVALIN® treatment schedule is used. 

Purpose: Both anti-CD20 antibodies (ibritumomab; ZEVALIN® and tositumomab; BEXXAR®) currently used for radioimmunotherapy of B cell non-Hodgkin’s lymphoma are murine immunoglobulins. The aim of this feasibility study was to evaluate the safety and efficacy of radioimmunotherapy with a human chimeric anti-CD20 antibody labelled with Yttrium-90 (90Y-rituximab) in patients with B cell lymphoma.

Methods: Patients with CD20+ B-cell lymphoma in partial remission or with progressive disease after at least one line of therapy were included. 90Y-rituximab was administered according to a similar schedule as currently approved by the European Medicines Agency for the treatment with 90Y-ibritumomab tiuxetan (ZEVALIN®): a first infusion of rituximab 250 mg/m² is repeated one week later and directly followed by the injection of 90Y-rituximab (14,8 MBq/kg). 18FDG-PET/CT was performed before treatment and repeated 3 months after for response assessment.

Results: Twenty-six patients were treated with 90Y-rituximab. Disease histologies included mainly follicular lymphomas (53%). Toxicity was primarily haematological. The incidence of grade 3-4 neutropenia, thrombocytopenia and anemia were 34%, 38%, and 8% respectively, with spontaneous recovery in all but one patient that needed autologous stem cell transplant for refractory thrombocytopenia. Among the relevant long-term side effects, one patient developed secondary myelodysplasia 2 years after the treatment. The overall response rate was 88% (95% CI: 70%-98%), including 65% complete metabolic responses and 23% partial metabolic responses. After a median follow-up of 29.6 months, the Kaplan-Meier estimated median progression-free survival was 9, 1 months (95% CI 6,1-17,9). Median time to next treatment was 24 months (95% CI: 12, 2-28).

Conclusion: Radioimmunotherapy with 90Y-rituximab in patients with relapsed CD20+ B-cell lymphomas is safe, well tolerated and effective when the ZEVALIN® treatment schedule is used.