University of Virginia Health System

U.VA. OFFERS INNOVATIVE TREATMENT FOR NON-HODGKIN'S LYMPHOMA

Doctors specializing in medical oncology and nuclear medicine at the University of Virginia Health System have teamed up to offer a new therapy for cancer patients with non-Hodgkin's lymphoma. Called Zevalin™ therapy, the treatment is a one-two punch that combines an antibody that targets lymphoma cells with a radioactive isotope that kills the cells with bursts of radiation. It's among the first therapies in a new type of targeted cancer treatment called radioimmunotherapy.

"The major direction in cancer research is to develop targeted therapies that have the ability to attack tumor cells more effectively while sparing normal tissue," said Dr. Michael E. Williams, professor of medicine and director of the hematologic malignancy program in the U.Va. Cancer Center. "This approach has the potential advantage of improving responses while decreasing side effects typically associated with traditional chemotherapy and radiation therapy. Zevalin is an important next step in immunologic therapy of lymphoma, taking advantage of the ability of the monoclonal antibody Rituxan to home in on the cancer cells and deliver a therapeutic radiation dose."

Non-Hodgkin's lymphoma (NHL) is a cancer of the lymphatic system that can arise almost anywhere in the body, most commonly in the lymph nodes. Lymphomas make up about 5 percent of all cancer cases. About 60,000 people are diagnosed with lymphoma each year in the U.S.

Approved by the FDA last year for treatment of relapsed and transformed indolent non-Hodgkin's lymphoma, Zevalin therapy is completed over a very short period of time, compared to conventional therapies.

On day one, patients are infused with Rituxan. They're then injected with a dose of the Zevalin antibody (ibritumomab tiuxetan) linked to a certain radioisotope. Doctors image the distribution of the radioisotope in the body. Seven to nine days later, patients receive a second Rituxan infusion, followed by an injection of the Zevalin antibody linked to a therapeutic radioisotope called yttrium-90.

These radiation-carrying antibodies circulate in the body, rapidly bind to the target proteins on the surface of cancer cells, and deliver their therapeutic payload. The manufacturer of Zevalin, IDEC Pharmaceuticals, said high-energy radiation emitted by yttrium-90 is absorbed by 90 percent of targeted cancer tissue and will penetrate into bulky tumors without damaging nearby organs.

IDEC said a phase III randomized trial of 143 patients with NHL showed an 80 percent overall response rate with Zevalin therapy compared to 56 percent on Rituxan alone. 30 percent of Zevalin patients experienced a complete remission compared to 16 percent on Rituxan alone.

Zevalin can be administered without hospitalization or the need for lead shielding, which can be the case in other types of radiation therapy. Patients must be evaluated for eligibility with regard to their type of lymphoma, their extent of prior therapy, and the presence or absence of bone marrow involvement.

February 11, 2003