1
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90-yttrium-ibritumomab tiuxetan as first-line treatment for follicular lymphoma: updated efficacy and safety results at an extended median follow-up of 9.6 years. Ann Hematol 2022; 101:781-788. [PMID: 35150296 PMCID: PMC8913448 DOI: 10.1007/s00277-022-04781-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 01/27/2022] [Indexed: 11/29/2022]
Abstract
Radioimmunotherapy with 90-yttrium-ibritumomab tiuxetan (90Y-IT) as first-line treatment in patients with follicular lymphoma (FL) demonstrated promising results with a complete remission (CR) rate of 56% and a median progression-free survival (PFS) of 26 months, when initially analyzed after a median follow-up of 30.6 months. The aim of this long-term follow-up was to investigate whether clinical benefits were maintained and new safety signals appeared. Fifty-nine patients, aged ≥ 50 years, with FL grade 1 to 3A in stages II to IV were treated with 90Y-IT as first-line therapy. If CR without evidence of minimal residual disease (MRD), partial response or stable disease was achieved 6 months after treatment, patients were observed without further treatment. Patients with CR but persisting MRD received consolidation therapy with rituximab. The primary endpoint was the clinical response rate. Secondary endpoints were time to progression, safety, and tolerability. After a median follow-up of 9.6 years, median PFS was 3.6 years, and 8-year PFS was 38.3%. Median overall survival (OS) was not reached during the extended follow-up, and 8-year OS amounted to 69.2%. Age 65 years and above or disease progression within 24 months of treatment were significantly associated with shorter OS. An important finding was the lack of new safety signals. In particular, no increase in secondary malignancies or transformation into aggressive lymphoma was observed compared to trials with a similar follow-up. In summary, 90Y-IT as first-line treatment demonstrates a favorable safety profile and long-term clinical activity in a substantial fraction of FL patients in need of therapy. ClinicalTrials.gov Identifier: NCT00772655.
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2
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Monoclonal antibody based radiopharmaceuticals for imaging and therapy. Curr Probl Cancer 2021; 45:100796. [PMID: 34657748 DOI: 10.1016/j.currproblcancer.2021.100796] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 08/03/2021] [Accepted: 09/02/2021] [Indexed: 11/23/2022]
Abstract
The concept of personalized medicine has been steadily growing for the past decades. Monoclonal antibodies (mAbs) are undoubtedly playing an important role in the transition away from conventional medical practice to a more tailored approach to deliver the best therapy with the highest safety margin to a specific patient. In certain instances, mAbs and antibody drug conjugates (ADCs) may represent the preferred therapeutic option for several types of cancers due to their high specificity and affinity to the antigen. Monoclonal antibodies can be labeled with specific radionuclides well-suited for PET (Positron Emission Tomography) or gamma camera scintigraphy. The use of radiolabeled mAbs allows the interrogation of specific biomarkers and assessment of tumor heterogeneity in vivo by a single diagnostic imaging scan that includes the whole-body in the field-of-view. Moreover, the same mAb can then be radiolabeled with an analogous radionuclide for the delivery of beta-minus radiation or alpha-particles as part of a radioimmunotherapy (RIT) approach. However, the path to develop, validate, and implement mAb-based radiopharmaceuticals from bench-to-bedside is complex due to the extensive pre-clinical experiments and toxicological studies required, and the necessity of labor-intensive clinical trials that often require multi-time-point imaging and blood draws for internal radiation dosimetry and pharmacokinetics. As more mAb-based radiopharmaceuticals have been developed and evaluated, the opportunities and limitations offered by mAbs have become better defined. Our aim with this manuscript is therefore to provide an overview of the recent advances in the development of mAb-based radiopharmaceuticals and their clinical applications in Oncology.
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3
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Sharda E, Patel RS, Juárez-Salcedo LM, Dalia S, Hanna CH, Gruhonjic H, Ponnaganti BS, Mhaskar R. Adverse events of radioimmunotherapy for non-Hodgkin lymphoma: A systematic review and meta-analysis. Leuk Res 2021; 108:106615. [PMID: 34052662 DOI: 10.1016/j.leukres.2021.106615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 05/08/2021] [Accepted: 05/09/2021] [Indexed: 11/25/2022]
Abstract
Non-Hodgkin's lymphoma continues to be a highly prevalent entity in the general population. Currently, there are multiple treatment schemes based on chemotherapeutic agents with a great success rate. However, there is a non-negligible percentage of patients who may relapse or be refractory. In this sense, new therapeutic options have emerged in the search for adequate responses, such as monoclonal antibodies that target the CD20 molecule. Another valid option is radioimmunotherapy (RIT), which combines using monoclonal antibodies for the specific targeting of malignant cells and radiation to destroy these cells. Despite the promising results that favor RIT in several clinical studies in different target populations and types of NHL, one situation to consider is the association of this therapy and second neoplasms (acute myeloid leukemia (AML) or myelodysplastic syndrome (MSD)). In this sense, we have proposed this meta-analysis to analyze the published information and determine the incidence of this association and determine this therapy's safety.
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Affiliation(s)
- Esha Sharda
- University of South Florida: Morsani College of Medicine, Tampa, United States
| | - Raahil S Patel
- University of South Florida: Morsani College of Medicine, Tampa, United States
| | | | - Samir Dalia
- Hematology/Oncology Department, Mercy Clinic Oncology and Hematology, Joplin, MO, United States.
| | - Catherine H Hanna
- University of South Florida: Morsani College of Medicine, Tampa, United States
| | - Hanan Gruhonjic
- University of South Florida: Morsani College of Medicine, Tampa, United States
| | - Bharat S Ponnaganti
- University of South Florida: Morsani College of Medicine, Tampa, United States
| | - Rahul Mhaskar
- University of South Florida: Morsani College of Medicine, Tampa, United States
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4
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López-Guillermo A, Canales MÁ, Dlouhy I, Mercadal S, Briones J, Martín García-Sancho A, Sancho JM, Moraleda JM, Terol MJ, Salar A, Palomera L, Gardella S, Jarque I, Ferrer S, Bargay J, López A, Panizo C, Muntañola A, Montalbán C, Conde E, Hernández MT, Soler A, García Marco JA, Deben G, Marín J, Tomás JF. A randomized phase II study comparing consolidation with a single dose of 90Y ibritumomab tiuxetan vs. maintenance with rituximab for two years in patients with newly diagnosed follicular lymphoma responding to R-CHOP. Long-term follow-up results. Leuk Lymphoma 2021; 63:93-100. [PMID: 34459702 DOI: 10.1080/10428194.2021.1971216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
This is a randomized phase-2 trial aimed to compare consolidation vs. maintenance in untreated patients with follicular lymphoma (FL) responding to induction. 146 patients were enrolled from 25 Spanish institutions (ZAR2007; ClinicalTrials.gov #NCT00662948). Patients in PR or CR/CR[u] after R-CHOP were randomized 1:1 to 90Y-ibritumomab-tiuxetan 0.4 mCi/kg (arm A) vs. rituximab 375 mg/m2 every 8 weeks for 2 years (arm B). After a median follow-up of 10.55 years, 53 patients eventually progressed with a 10-year PFS of 50% vs. 56% for patients in arm A and B, respectively (HR = 1.42; p > 0.1). No significant differences were seen in OS (10-year OS 78% vs. 84.5%; HR = 1.39, p > .1). Patients receiving 90Y-ibritumomab-tiuxetan showed higher incidence of second neoplasms than those in arm B (10-year cumulative incidence 18.5 vs. 2%, respectively; p = .038). In conclusion, in FL patients responding to R-CHOP, no significant differences were found between consolidation and maintenance, although with higher late toxicity for consolidation.
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Affiliation(s)
| | | | - Ivan Dlouhy
- Hematopathology Department, Hospital Clinic de Barcelona, Barcelona, Spain
| | | | | | | | - Juan Manuel Sancho
- Hematology Department, ICO-IJC-Hospital Germans Trias i Pujol, Badalona, Spain
| | | | - María José Terol
- Department of Haematology and Medical Oncology, Hospital Clinico, Valencia, Spain
| | - Antonio Salar
- Hematology Department, Hospital del Mar, Barcelona, Spain
| | - Luis Palomera
- Hematology Department, Hospital Clínico Lozano Blesa, Zaragoza, Spain
| | | | - Isidro Jarque
- Hematology Department, Hospital La Fe, CIBERONC - Instituto Carlos III, Valencia, Spain
| | | | | | - Andrés López
- Hematology Department, Hospital Vall d'Hebron, Barcelona, Spain
| | - Carlos Panizo
- Hematology Department, Clínica Universidad de Navarra, Pamplona, Spain
| | - Anna Muntañola
- Hematology Department, Hospital Universitari Mutua de Terrassa, Terrassa, Spain
| | | | - Eulogio Conde
- Department of Hematology, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Miguel T Hernández
- Hematology Department, Hospital Universitario de Canarias, Tenerife, Spain
| | - Alfons Soler
- Hematology Department, Hospital Parc Taulí, Sabadell, Spain
| | | | - Guillermo Deben
- Hematology Department, Hospital Juan Canalejo, La Coruña, Spain
| | - Julián Marín
- Hematology Department, Hospital Nuestra Señora de Aránzazu, San Sebastián, Spain
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5
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Miura K, Tsujimura H, Masaki Y, Iino M, Takizawa J, Maeda Y, Yamamoto K, Tamura S, Yoshida A, Yagi H, Yoshida I, Kitazume K, Masunari T, Choi I, Kakinoki Y, Suzuki R, Yoshino T, Nakamura S, Hatta Y, Yoshida T, Kanno M. Consolidation with 90 Yttrium-ibritumomab tiuxetan after bendamustine and rituximab for relapsed follicular lymphoma. Hematol Oncol 2020; 39:51-59. [PMID: 32978820 DOI: 10.1002/hon.2809] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 09/19/2020] [Accepted: 09/19/2020] [Indexed: 11/07/2022]
Abstract
Bendamustine and rituximab (BR) are widely used in patients with follicular lymphoma (FL) previously treated with conventional immunochemotherapy, but the role of consolidation radioimmunotherapy in these patients is unknown. This study evaluated the efficacy and safety of consolidation with 90 Yttrium-ibritumomab tiuxetan (90 Y-IT) after re-induction therapy with BR in patients with previously treated FL. This study included adult patients with relapsed FL who had undergone one or two prior therapies. Re-induction therapy with BR was administered every 4 weeks up to 4-6 cycles. If patients achieved at least partial response, 90 Y-IT was administered as consolidation therapy. The primary endpoint was 2-year progression-free survival (PFS) after consolidation. A total of 24 FL patients (median age 60 years) who had undergone one (n = 17) or two (n = 7) prior treatments received BR. After BR therapy, 22 patients proceeded to consolidation with 90 Y-IT, resulting in an overall 88% response rate to the protocol treatment. Within a median observation period of 46.8 months, the estimated 2-year PFS rate after the consolidation among the 22 patients receiving 90 Y-IT was 59% (95% confidence interval [CI], 38%-77%). Patients whose remission after previous treatment had lasted ≥2 years had a significantly higher 2-year PFS rate than patients whose remission after previous treatment had been <2 years (68% vs. 33%, Wilcoxon p = 0.0211). Major adverse events during the protocol treatment and within 2 years after the consolidation were hematological toxicities, but they were generally acceptable. Consequently, the estimated 2-year overall survival after the consolidation was 95% (95% CI, 74%-99%). In conclusion, in a subset of patients with previously treated FL, 90 Y-IT consolidation after BR re-induction conferred a durable remission, indicating that consolidation therapy using 90 Y-IT may be a novel therapeutic option for patients with relapsed FL (UMIN000008793).
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Affiliation(s)
- Katsuhiro Miura
- Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | | | - Yasufumi Masaki
- Department of Hematology and Immunology, Kanazawa Medical University, Ishikawa, Japan
| | - Masaki Iino
- Department of Medical Oncology, Yamanashi Prefectural Central Hospital, Kofu, Japan
| | - Jun Takizawa
- Department of Hematology, Endocrinology and Metabolism, Niigata University Faculty of Medicine, Niigata, Japan
| | - Yoshinobu Maeda
- Department of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | | | - Shinobu Tamura
- Department of Hematology/Oncology, Kinan Hospital, Tanabe, Japan
| | - Akiyo Yoshida
- Department of Hematology, Toyama Prefectural Central Hospital, Toyama, Japan
| | - Hideo Yagi
- Department of Hematology and Oncology, Nara Prefecture General Medical Center, Nara, Japan
| | - Isao Yoshida
- Department of Hematologic Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Koichi Kitazume
- Department of Hematology, Showa General Hospital, Tokyo, Japan
| | - Taro Masunari
- Department of Infectious Diseases, Chugoku Central Hospital, Fukuyama, Japan
| | - Ilseung Choi
- Department of Hematology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | | | - Ritsuro Suzuki
- Department of Oncology/Hematology, Innovative Cancer Center, Shimane University Hospital, Izumo, Japan
| | - Tadashi Yoshino
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Shigeo Nakamura
- Department of Pathology and Biological Response, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshihiro Hatta
- Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Takashi Yoshida
- Member, Society of Lymphoma Treatment in Japan, Kashihara, Japan
| | - Masatoshi Kanno
- Oncology Center, Nara Medical University Hospital, Kashihara, Japan
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6
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Etienne F, Berthaud M, Nguyen F, Bernardeau K, Maurel C, Bodet-Milin C, Diab M, Abadie J, Gouilleux-Gruart V, Vidal A, Bourgeois M, Chouin N, Ibisch C, Davodeau F. SPECT-CT Imaging of Dog Spontaneous Diffuse Large B-Cell Lymphoma Targeting CD22 for the Implementation of a Relevant Preclinical Model for Human. Front Oncol 2020; 10:20. [PMID: 32117707 PMCID: PMC7018706 DOI: 10.3389/fonc.2020.00020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 01/08/2020] [Indexed: 11/13/2022] Open
Abstract
Antibodies directed against CD22 have been used in radioimmunotherapy (RIT) clinical trials to treat patients with diffuse large B-cell lymphoma (DLBCL) with promising results. However, relevant preclinical models are needed to facilitate the evaluation and optimization of new protocols. Spontaneous DLBCL in dogs is a tumor model that may help accelerate the development of new methodologies and therapeutic strategies for RIT targeting CD22. Seven murine monoclonal antibodies specific for canine CD22 were produced by the hybridoma method and characterized. The antibodies' affinity and epitopic maps, their internalization capability and usefulness for diagnosis in immunohistochemistry were determined. Biodistribution and PET imaging on a mouse xenogeneic model of dog DLBCL was used to choose the most promising antibody for our purposes. PET-CT results confirmed biodistribution study observations and allowed tumor localization. The selected antibody, 10C6, was successfully used on a dog with spontaneous DLBCL for SPECT-CT imaging in the context of disease staging, validating its efficacy for diagnosis and the feasibility of future RIT assays. This first attempt at phenotypic imaging on dogs paves the way to implementing quantitative imaging methodologies that would be transposable to humans in a theranostic approach. Taking into account the feedback of existing human radioimmunotherapy clinical trials targeting CD22, animal trials are planned to investigate protocol improvements that are difficult to consider in humans due to ethical concerns.
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Affiliation(s)
- Floriane Etienne
- CRCINA, INSERM, CNRS, Université de Nantes, Université d'Angers, Nantes, France.,AMaROC, Oniris (Nantes Atlantic College of Veterinary Medicine, Food Science and Engineering), Nantes, France
| | - Maxime Berthaud
- CRCINA, INSERM, CNRS, Université de Nantes, Université d'Angers, Nantes, France
| | - Frédérique Nguyen
- CRCINA, INSERM, CNRS, Université de Nantes, Université d'Angers, Nantes, France.,AMaROC, Oniris (Nantes Atlantic College of Veterinary Medicine, Food Science and Engineering), Nantes, France
| | - Karine Bernardeau
- CRCINA, INSERM, CNRS, Université de Nantes, Université d'Angers, Nantes, France.,P2R "Production de Protéines Recombinantes", CRCINA, SFR-Santé, INSERM, CNRS, UNIV Nantes, CHU Nantes, Nantes, France
| | - Catherine Maurel
- CRCINA, INSERM, CNRS, Université de Nantes, Université d'Angers, Nantes, France
| | - Caroline Bodet-Milin
- CRCINA, INSERM, CNRS, Université de Nantes, Université d'Angers, Nantes, France.,Nuclear Medicine, University Hospital, Nantes, France
| | - Maya Diab
- CRCINA, INSERM, CNRS, Université de Nantes, Université d'Angers, Nantes, France
| | - Jérôme Abadie
- CRCINA, INSERM, CNRS, Université de Nantes, Université d'Angers, Nantes, France.,AMaROC, Oniris (Nantes Atlantic College of Veterinary Medicine, Food Science and Engineering), Nantes, France
| | | | - Aurélien Vidal
- Groupement d'Intérêt Public ARRONAX Cyclotron, Saint-Herblain, France
| | - Mickaël Bourgeois
- CRCINA, INSERM, CNRS, Université de Nantes, Université d'Angers, Nantes, France.,Groupement d'Intérêt Public ARRONAX Cyclotron, Saint-Herblain, France
| | - Nicolas Chouin
- CRCINA, INSERM, CNRS, Université de Nantes, Université d'Angers, Nantes, France.,AMaROC, Oniris (Nantes Atlantic College of Veterinary Medicine, Food Science and Engineering), Nantes, France
| | - Catherine Ibisch
- CRCINA, INSERM, CNRS, Université de Nantes, Université d'Angers, Nantes, France.,AMaROC, Oniris (Nantes Atlantic College of Veterinary Medicine, Food Science and Engineering), Nantes, France
| | - François Davodeau
- CRCINA, INSERM, CNRS, Université de Nantes, Université d'Angers, Nantes, France
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7
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Sutamtewagul G, Link BK. Novel treatment approaches and future perspectives in follicular lymphoma. Ther Adv Hematol 2019; 10:2040620718820510. [PMID: 30719267 PMCID: PMC6348550 DOI: 10.1177/2040620718820510] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 11/30/2018] [Indexed: 12/14/2022] Open
Abstract
Follicular lymphoma (FL) is a common B-cell malignancy characterized by relatively indolent growth and incurability with an expected lifetime course of serial intermittent treatment courses. Many patients with FL have lives shortened by the disease and despite a relatively favorable prognosis relative to other incurable systemic malignancies, optimal management of FL has not been achieved. This review focuses on identifying both patients for whom novel therapies might be most beneficial as well as systematically reviewing novel strategies at various levels of investigation. Prognostic markers incorporating clinical measurements and tumor genetics are discussed, yet at the time of diagnosis do not yet powerfully discriminate patients for whom specific strategies are beneficial. Reassessment of prognosis after evaluating the response to initial therapy is the most powerful identifier of those in need of novel management strategies. For initial therapy of high burden systemic disease, anti-CD20 antibody along with chemotherapy or immunomodulators all offer relatively similar effects on overall survival with subtly different effects on progression-free survival and quality of life. Several new agents currently under investigation in the upfront setting are discussed. Perhaps the best testing ground for novel therapies is in patients with early relapse following initial immunochemotherapy. Ongoing research in multiple therapy classes including, novel monoclonal antibodies, antibody drug conjugates, immunomodulatory agents, intracellular pathway inhibitors, immune checkpoint inhibitors, and epigenetic regulators are discussed herein.
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Affiliation(s)
- Grerk Sutamtewagul
- Division of Hematology, Oncology, and Blood & Marrow Transplantation, Department of Internal Medicine, University of Iowa Carver College of Medicine, 200 Hawkins Dr., C305 GH, Iowa City, IA 52242, USA
| | - Brian K. Link
- Division of Hematology, Oncology, and Blood & Marrow Transplantation, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA
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8
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Hohloch K, Windemuth-Kieselbach C, Kolz J, Zinzani PL, Cacchione R, Jurczak W, Bischof Delaloye A, Trümper L, Scholz CW. Radioimmunotherapy (RIT) for Follicular Lymphoma achieves long term lymphoma control in first line and at relapse: 8-year follow-up data of 281 patients from the international RIT-registry. Br J Haematol 2018; 184:949-956. [PMID: 30515751 DOI: 10.1111/bjh.15712] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Revised: 11/05/2018] [Indexed: 11/28/2022]
Abstract
To assess efficacy of radioimmunotherapy (RIT) in follicular lymphoma, data from 281 patients collected in the RIT Network, with a median follow-up of 8·2 years after RIT were analysed. RIT was given at first line in 18·5% and at relapse in 81·5%. Following first line therapy, 76·9% achieved complete remission (CR), 9·6% partial remission (PR), 1·9% stable disease (SD) and 1·9% had progressive disease (PD); response was not documented in 9·7%. At relapse, the rate of CR was 48·5% and that of PR was 16·6%, SD 2·6% and PD 10·5%; response was not documented in 21·8%. After median follow-up of 8·2 years, median progression-free survival (PFS) for all was 2·54 years, median overall survival (OS) was not reached. Median PFS and OS (both not reached) were significantly better in first line, compared to RIT at relapse (PFS, 2·11 years; OS, 10·8 years; P = 0·0037 and P = 0·0021, respectively). Overall 8-year PFS was 33·9%, 53·6% for first line and 29·6% for relapsed individuals. Overall 8-year OS was 58·8%, 78·1% for first line and 54·5% for relapsed patients. Thirty-five patients (12·5%) developed secondary malignancy and 16 patients (5·7%) experienced transformation into aggressive lymphoma. RIT is a safe and effective treatment option for follicular lymphoma, both at front line and relapse with an 8-year PFS of 53·6% and 29·6%, respectively.
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Affiliation(s)
- Karin Hohloch
- Kantonsspital Graubünden, Department of Haematology and Oncology, Chur, Switzerland.,Department of Haematology and Oncology, Georg August University, Goettingen, Germany
| | | | - Julia Kolz
- Department of Haematology and Oncology, Georg August University, Goettingen, Germany
| | - Pier Luigi Zinzani
- Istituto di Ematologia e Oncologia Medica, Università di Bologna, Bologna, Italy
| | - Roberto Cacchione
- CEMIC, Centro de Educación, Médica e Investigaciones Clínical, "Norberto Quirno", Buenos Aires, Argentina
| | | | | | - Lorenz Trümper
- Istituto di Ematologia e Oncologia Medica, Università di Bologna, Bologna, Italy
| | - Christian W Scholz
- Department of Haematology and Oncology, Vivantes Klinikum Am Urban, Berlin, Germany
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9
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Englinger B, Pirker C, Heffeter P, Terenzi A, Kowol CR, Keppler BK, Berger W. Metal Drugs and the Anticancer Immune Response. Chem Rev 2018; 119:1519-1624. [DOI: 10.1021/acs.chemrev.8b00396] [Citation(s) in RCA: 174] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Bernhard Englinger
- Institute of Cancer Research and Comprehensive Cancer Center, Department of Medicine I, Medical University of Vienna, Borschkegasse 8a, A-1090 Vienna, Austria
| | - Christine Pirker
- Institute of Cancer Research and Comprehensive Cancer Center, Department of Medicine I, Medical University of Vienna, Borschkegasse 8a, A-1090 Vienna, Austria
| | - Petra Heffeter
- Institute of Cancer Research and Comprehensive Cancer Center, Department of Medicine I, Medical University of Vienna, Borschkegasse 8a, A-1090 Vienna, Austria
- Research Cluster “Translational Cancer Therapy Research”, University of Vienna and Medical University of Vienna, Vienna, Austria
| | - Alessio Terenzi
- Research Cluster “Translational Cancer Therapy Research”, University of Vienna and Medical University of Vienna, Vienna, Austria
- Institute of Inorganic Chemistry, Faculty of Chemistry, University of Vienna, Waehringer Strasse 42, A-1090 Vienna, Austria
| | - Christian R. Kowol
- Research Cluster “Translational Cancer Therapy Research”, University of Vienna and Medical University of Vienna, Vienna, Austria
- Institute of Inorganic Chemistry, Faculty of Chemistry, University of Vienna, Waehringer Strasse 42, A-1090 Vienna, Austria
| | - Bernhard K. Keppler
- Research Cluster “Translational Cancer Therapy Research”, University of Vienna and Medical University of Vienna, Vienna, Austria
- Institute of Inorganic Chemistry, Faculty of Chemistry, University of Vienna, Waehringer Strasse 42, A-1090 Vienna, Austria
| | - Walter Berger
- Institute of Cancer Research and Comprehensive Cancer Center, Department of Medicine I, Medical University of Vienna, Borschkegasse 8a, A-1090 Vienna, Austria
- Research Cluster “Translational Cancer Therapy Research”, University of Vienna and Medical University of Vienna, Vienna, Austria
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10
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Tsukamoto N, Yokohama A, Higuchi T, Mitsui T, Koiso H, Takizawa M, Shimizu H, Ishizaki T, Matsumoto M, Toyama K, Sakura T, Ogura H, Saitoh T, Ishida F, Murakami H, Tsushima Y, Handa H. Tumor long-axis diameter and SUVmax predict long-term responders in 90Y-ibritumomab tiuxetan monotherapy. Int J Hematol 2018; 109:91-97. [PMID: 30203253 DOI: 10.1007/s12185-018-2526-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 09/01/2018] [Accepted: 09/03/2018] [Indexed: 11/29/2022]
Abstract
90Y-ibritumomab tiuxetan (90Y-IT) is widely used, but the factors responsible for its optimal treatment effects are unknown. We enrolled 34 patients with relapsed indolent lymphoma treated with 90Y-IT monotherapy at Gunma University Hospital between 2003 and 2014 in the present study. Clinical data including computed tomography and 18-Fluoro-deoxyglucose positron emission tomography were retrospectively analyzed. The overall response rate and complete response rate were 91% and 82%, respectively. The median progression-free survival (PFS) and overall survival were 32 months and not reached, respectively. In univariate analysis, tumor long-axis diameter ≤ 2.5 cm, maximum standardized uptake value (SUVmax) ≤ 6.5, localized disease, normal levels of serum soluble interleukin-2 receptor, and the number of involved nodal sites ≤ 3 immediately prior to 90Y-IT were associated with median PFS greater than 6 years. However, in multivariate analysis, only tumor long-axis diameter ≤ 2.5 cm and SUVmax ≤ 6.5 affected PFS [hazard ratio (HR) 0.130, P = 0.0021 and HR 0.283, P = 0.0311, respectively]. Patients with only one prior regimen needed less granulocyte colony-stimulating factor and platelet transfusion. Thus, 90Y-IT treatment should be considered for patients with indolent lymphoma in first relapse who have tumor long-axis diameter ≤ 2.5 cm and SUVmax ≤ 6.5.
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Affiliation(s)
- Norifumi Tsukamoto
- Oncology Center, Gunma University Hospital, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8511, Japan. .,Department of Hematology, Gunma University Graduate School of Medicine, Maebashi, Japan.
| | - Akihiko Yokohama
- Department of Hematology, Gunma University Graduate School of Medicine, Maebashi, Japan.,Transfusion Service, Gunma University Hospital, Maebashi, Japan
| | - Tetsuya Higuchi
- Department of Diagnostic Radiology and Nuclear Medicine, University Graduate School of Medicine, Maebashi, Japan
| | - Takeki Mitsui
- Department of Hematology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Hiromi Koiso
- Department of Hematology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Makiko Takizawa
- Department of Hematology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Hiroaki Shimizu
- Department of Hematology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Takuma Ishizaki
- Department of Hematology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Morio Matsumoto
- Department of Hematology, National Hospital Organization Shibukawa Medical Center, Shibukawa, Japan
| | - Kohtaro Toyama
- Division of Internal Medicine, Fujioka General Hospital, Fujioka, Japan
| | - Tohru Sakura
- Division of Internal Medicine, Saiseikai Maebashi Hospital, Maebashi, Japan
| | - Hidemi Ogura
- Division of Internal Medicine, Maebashi Red Cross Hospital, Maebashi, Japan
| | - Takayuki Saitoh
- Department of Laboratory Sciences, Gunma University Graduate School of Health Sciences, Maebashi, Japan
| | - Fumihiro Ishida
- Department of Biomedical Laboratory Medicine, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Hirokazu Murakami
- Department of Laboratory Sciences, Gunma University Graduate School of Health Sciences, Maebashi, Japan
| | - Yoshito Tsushima
- Department of Diagnostic Radiology and Nuclear Medicine, University Graduate School of Medicine, Maebashi, Japan
| | - Hiroshi Handa
- Department of Hematology, Gunma University Graduate School of Medicine, Maebashi, Japan
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11
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Eskian M, Khorasanizadeh M, Zinzani PL, Rezaei N. Radioimmunotherapy as the first line of treatment in non-Hodgkin lymphoma. Immunotherapy 2018; 10:699-711. [DOI: 10.2217/imt-2017-0169] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Non-Hodgkin lymphoma (NHL) is the most common hematologic malignancy. The estimated deaths and new cases of NHL in the USA in 2018 have reached 19,910 and 74,680, respectively, with 5-year survival rate of 71%. Therapeutic interventions for NHL consist of chemotherapy, radiation therapy and immunotherapy. Radioimmunotherapy (RIT) is a potential alternative treatment for NHL that is currently used in different lines of treatment. Studies show that nuclear medicine physicians and radiation oncologists are not yet certain about the proper line for administration of RIT. Herein, we have reviewed the efficiency and toxicity of RIT as the first line of treatment, and discussed potential novel indications, and strategies such as modifying induction therapy and using rituximab maintenance to optimize the efficiency of RIT as the first line of treatment. Our review indicates that it is more logical to postpone conventional therapies to the second or third lines of treatment instead of RIT.
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Affiliation(s)
- Mahsa Eskian
- Department of Immunology, Research Center for Immunodeficiencies, Children's Medical Center Hospital, Tehran University of Medical Sciences Dr. Qarib St, Keshavarz Blvd, Tehran 14194, Iran
- Department of Immunology, Cancer Immunology Project (CIP), Universal Scientific Education & Research Network (USERN), Tehran 14194, Iran
| | - MirHojjat Khorasanizadeh
- Department of Immunology, Research Center for Immunodeficiencies, Children's Medical Center Hospital, Tehran University of Medical Sciences Dr. Qarib St, Keshavarz Blvd, Tehran 14194, Iran
- Department of Immunology, Cancer Immunology Project (CIP), Universal Scientific Education & Research Network (USERN), Tehran 14194, Iran
| | - Pier L Zinzani
- Department of Hematology and Oncological Sciences ‘L. e A. Seràgnoli,’ University of Bologna, Bologna 40138, Italy
| | - Nima Rezaei
- Department of Immunology, Research Center for Immunodeficiencies, Children's Medical Center Hospital, Tehran University of Medical Sciences Dr. Qarib St, Keshavarz Blvd, Tehran 14194, Iran
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran 14194, Iran
- Network of Immunity in Infection, Malignancy & Autoimmunity (NIIMA), Universal Scientific Education & Research Network (USERN), Boston, MA, USA
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12
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Mitoxantrone induces apoptosis in osteosarcoma cells through regulation of the Akt/FOXO3 pathway. Oncol Lett 2018; 15:9687-9696. [PMID: 29928344 PMCID: PMC6004704 DOI: 10.3892/ol.2018.8547] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 03/09/2018] [Indexed: 12/21/2022] Open
Abstract
The outcome of chemotherapy for osteosarcoma have improved during the past decade and more patients have access to combination chemotherapy, but there has been no significant clinical progress in the patient survival rate. Recently, forkhead-box O3 (FOXO3) was identified as a pivotal transcription factor responsible for the transcriptional regulation of genes associated with suppression of cancer. The purpose of the present study was to screen small chemicals activating FOXO3 and elucidate their underlying mechanism. Using a drug discovery platform based on the phosphorylation status of FOXO3 in osteosarcoma cells, mitoxantrone (MTZ), a type of DNA-damaging agent, was selected as a possible FOXO3 activator from the food and drug administration-approved drug library. MTZ treatments significantly inhibited the phosphorylation level of Akt-pS473 and caused nuclear localization of FOXO3 in osteosarcoma cells. MTZ treatment inhibited proliferation in osteosarcoma cells in vitro, whereas silencing FOXO3 potently attenuates MTZ-mediated apoptosis in osteosarcoma cells. Taken together, the results indicated that MTZ induces apoptosis in osteosarcoma cells through an Akt/FOXO3-dependent mechanism.
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13
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Abou Zahr A, Kavi AM, Mukherjee S, Zeidan AM. Therapy-related myelodysplastic syndromes, or are they? Blood Rev 2016; 31:119-128. [PMID: 27923516 DOI: 10.1016/j.blre.2016.11.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 09/14/2016] [Accepted: 11/22/2016] [Indexed: 12/12/2022]
Abstract
The incidence of therapy-related myelodysplastic syndromes (t-MDS) is increasing as the number of cancer survivors is increasing. While t-MDS is currently defined descriptively by prior receipt of chemotherapy and/or radiotherapy, some forms of MDS that occur post localized radiation monotherapy, biologically and clinically resemble de novo (d)-MDS more than t-MDS, and therefore may not be truly therapy-related. Although patients with t-MDS, as a group, fare worse than patients with d-MDS, a variation in individual outcomes of patients with t-MDS has increasingly been appreciated. As such, accurate risk stratification is important for counseling of patients and for clinical decision making. Most of the current clinical tools used for prognostication in t-MDS were developed for d-MDS and were not specifically validated in patients with t-MDS. The management of patients with t-MDS remains challenging, highlighting the importance of developing effective prevention strategies as well as newer, targeted, and rationally-designed therapeutic interventions.
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Affiliation(s)
- Abdallah Abou Zahr
- Section of Hematology/Oncology, Department of Internal Medicine, Mount Sinai Beth Israel, New York City, New York, NY, USA
| | - Ami M Kavi
- Department of Internal Medicine, Mount Sinai Beth Israel, New York City, New York, NY, USA
| | - Sudipto Mukherjee
- Hematology and Medical Oncology, Cleveland Clinic, Cleveland, OH, USA
| | - Amer M Zeidan
- Section of Hematology, Department of Medicine, Yale University, New Haven, CT, USA.
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14
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Casadei B, Pellegrini C, Pulsoni A, Annechini G, De Renzo A, Stefoni V, Broccoli A, Gandolfi L, Quirini F, Tonialini L, Morigi A, Argnani L, Zinzani PL. 90-yttrium-ibritumomab tiuxetan consolidation of fludarabine, mitoxantrone, rituximab in intermediate/high-risk follicular lymphoma: updated long-term results after a median follow-up of 7 years. Cancer Med 2016; 5:1093-7. [PMID: 26990782 PMCID: PMC4924367 DOI: 10.1002/cam4.684] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 02/03/2016] [Accepted: 02/04/2016] [Indexed: 11/25/2022] Open
Abstract
Radioimmunotherapy (RIT) after an induction phase with conventional chemoimmunotherapy became an attractive strategy of consolidation for patients with advanced follicular lymphoma: in particular, in many studies RIT was represented by yttrium-90-ibritumomab tiuxetan ((90) Y-IT). Independently by the different front-line treatment, updates on the long-term follow-up of these studies are needed because the disease course of follicular lymphoma is characterised by multiple relapses and progressively shorter durations of response. We report updated long-term efficacy and toxicity results of a multicenter phase II study on sequential treatment with four cycles of fludarabine, mitoxantrone, and rituximab followed by (90) Y-IT as front-line therapy for untreated patients with intermediate/high-risk follicular lymphoma. With a median follow-up of 84 months, only 19/49 (38.8%) complete response patients relapsed, yielding an estimated long-term disease-free survival of 62.6%. The 7-year overall survival was 72.7%. Four (7.3%) second acute myeloid leukemia occurred, with a median time following RIT of 42 months. A relevant patients' responsiveness to subsequent therapies occurred: approximately 65% of relapsed patients obtained a good clinical response after the second-line treatment. These data represented the first evidence of a real role even in the long period of 90Y-IT after a fludarabine-containing regimen plus rituximab in the treatment of high-risk follicular lymphoma.
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Affiliation(s)
- Beatrice Casadei
- Institute of Hematology “L. e A. Seràgnoli”University of BolognaBolognaItaly
| | - Cinzia Pellegrini
- Institute of Hematology “L. e A. Seràgnoli”University of BolognaBolognaItaly
| | - Alessandro Pulsoni
- Department of Cellular Biotechnologies and Hematology“La Sapienza” UniversityRomaItaly
| | - Giorgia Annechini
- Department of Cellular Biotechnologies and Hematology“La Sapienza” UniversityRomaItaly
| | | | - Vittorio Stefoni
- Institute of Hematology “L. e A. Seràgnoli”University of BolognaBolognaItaly
| | - Alessandro Broccoli
- Institute of Hematology “L. e A. Seràgnoli”University of BolognaBolognaItaly
| | - Letizia Gandolfi
- Institute of Hematology “L. e A. Seràgnoli”University of BolognaBolognaItaly
| | - Federica Quirini
- Institute of Hematology “L. e A. Seràgnoli”University of BolognaBolognaItaly
| | - Lorenzo Tonialini
- Institute of Hematology “L. e A. Seràgnoli”University of BolognaBolognaItaly
| | - Alice Morigi
- Institute of Hematology “L. e A. Seràgnoli”University of BolognaBolognaItaly
| | - Lisa Argnani
- Institute of Hematology “L. e A. Seràgnoli”University of BolognaBolognaItaly
| | - Pier Luigi Zinzani
- Institute of Hematology “L. e A. Seràgnoli”University of BolognaBolognaItaly
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