131-Iodine Tositumomab in lymphoma

M.C. Cheung, J.A. MacEachern, A.E. Haynes, R.M. Meyer, K. Imrie, and the Members of the Hematology Disease Site Group of the Cancer Care Ontario Program in Evidence-Based Care


Radioimmunoconjugates are radioisotope-bound monoclonal antibodies that target radiation specifically to sites of lymphoma involvement. Initial studies of 131I-tositumomab in non-Hodgkin’s lymphoma (NHL) have suggested benefit in patients with relapsed or refractory indolent disease. However, the routine adoption of this agent is tempered by concerns of associated toxicities and unclear long-term benefit. A comprehensive search for studies on 131I-tositumomab use in lymphoma was completed. The aims of this systematic review were to summarize and evaluate the evidence on: (1) the benefits and risks of this novel therapy; (2) predictors for response and toxicity; and (3) the role of dosimetry and imaging studies prior to treatment. A total of 18 trials investigating the use of 131I-tositumomab for the treatment of adult patients with NHL were identified. In trials of patients with relapsed or refractory indolent NHL, overall response rates ranged from 67%-83%. In patients with follicular NHL refractory to the monoclonal antibody rituximab response rates remained high (65-72%). However, in rituximab-naïve patients with relapsed or refractory indolent or transformed NHL, improvements in time-to-progression or survival have not clearly been established. 131I-tositumomab is an active agent in relapsed and refractory non-Hodgkin’s lymphoma that should be considered in select patients.

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DOI: http://dx.doi.org/10.3747/co.v16i5.385

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ISSN: 1198-0052 (Print) ISSN: 1718-7729 (Online)