Zevalin™ Therapeutic Regimen is available at UVA HSC!

Radioimmunotherapy is a new area of cancer treatment that combines the targeting abilities of monoclonal antibodies with the cell-damaging effects of localized radiation. Radioimmunotherapies are made by linking monoclonal antibodies that are developed specifically to recognize and attach to substances on the surface of certain cells to radioactive isotopes. When infused into a patient, these radiation-carrying antibodies circulate in the body until they locate and bind to the surface of specific cells, and then deliver their localized radiation directly to malignant cells.  Lymphoma tumors are very sensitive to radiation, but targeting external beam radiation to cancerous immune system cells throughout the body is difficult. 

Zevalin™ was the first radioimmunotherapy to receive FDA approval.  Zevalin™, as part of the Zevalin™ therapeutic regimen, is indicated for the treatment of relapsed or refractory low grade, follicular, or transformed B-cell non-Hodgkin's Lymphoma (NHL) including patients with Rituxan® (rituximab) refractory follicular NHL. Zevalin™ is not recommended for patients with platelets below 100,000.

Zevalin™ therapeutic regimen is available at UVA HSC.  The regimen is administered through the coordinated efforts of the Divisions of Nuclear Medicine and Hematology-Oncology.  Patients are first evaluated by a UVA physician in Hematology-Oncology, and if appropriate, referred to Nuclear Medicine for further consideration for Zevalin™ therapy.   

The Zevalin™ therapeutic regimen consists of Rituxan preceding Indium-111 Zevalin™ followed seven to nine days later by a second infusion of Rituxan prior to Yttrium-90 Zevalin™.  Zevalin™ binds to the CD20 antigen on malignant and normal B cells.  The Yttrium-90 attached to the Zevalin™ antibody provides the localized therapeutic radiation.  Following treatment, normal B cells generally are replenished by remaining progenitor cells within six to nine months following therapy.   

Regimen Completed in One Week
The Zevalin™ therapeutic regimen involves a series of injections and nuclear medicine scans. Zevalin™ therapy consists of two low doses of Rituxan, an imaging dose, two or three whole body scans and a therapeutic dose, which are all delivered on an outpatient basis over eight days. The patient first receives Rituxan followed by a form of Zevalin™ with a low dose of radioactive chemical (Indium-111) for diagnostic imaging purposes. If the scans shows that the patient’s tumor is properly targeted, the patient receives Rituxan again with a form of Zevalin™ that has a different radioactive chemical (Yttrium-90) that provide the localized radiation therapy.

Important Information about Zevalin™ :

  • Patients who are found to have altered distribution on the scan following the In-111 Zevalin™ infusion should not continue treatment with this regimen.  
  • The Zevalin™ treatment regimen is more toxic than treatment with Rituxan. More than half of the patients in the clinical trials experienced serious reductions in blood-cell counts, including white blood cells and platelets lasting for 3 to 4 weeks.
  • Hemorrhages, some fatal, and life threatening infections occurred in a small number of patients. Because of these concerns, the Zevalin™ therapeutic regimen is only approved for patients who have failed other treatments.
  • Fatal infusion reactions have occurred with the infusion of Rituxan, one of the components of the Zevalin™ regimen. This severe reaction is most often associated with the first infusion of Rituxan, and if it occurs the Zevalin™ regimen should be immediately stopped and appropriate medical treatment initiated.

Where to find more information about Zevalin™ :

Visit the FDA web site at : http://www.fda.gov/bbs/topics/ANSWERS/2002/ANS01138.html.