Radioimmuntherapie (RAIT) bei B-Non-Hodgkin-Lymphomen (NHL) - ein Überblick

Zusammenfassung

Aufgrund überzeugender Studienergebnisse bei Patienten mit einem rezidivierten oder refraktären B-NHL sind ⁹⁰Y-Ibritumomab-Tiuxetan und ¹³¹I-Tositumomab zur Therapie von follikulären Lymphomen in der Rezidivsituation (⁹⁰Y-Ibritumomab-Tiuxetan in Europa) und zur Therapie von rezidivierten oder refraktären Low-grade-B-NHL sowie transformierten B-NHLs (¹³¹I-Tositumomab in den USA) zugelassen. Zahlreiche Studien haben gezeigt, dass beide Radioimmunkonjugate sowohl in der Erstlinientherapie als auch in der Konsolidierungstherapie nach Erstlinientherapie entweder als Monosubtanz als auch in einem multimodalen Konzept außerordentlich wirkungsvoll sind. Ergebnisse zur RAIT bei aggressiven Lymphomen sind ebenfalls vielversprechend. Myeloablative Hochdosisprotokolle mit Stammzellgabe (ASCT) zeichnen sich durch eine hohe Rate kompletter und zum Teil dauerhafter Remissionen aus. Fraktionierte Therapien erscheinen durchaus erfolgversprechend, sind aber zurzeit nur unzureichend und nur für die Rezidivsituation evaluiert. Vom derzeitigen Kenntnisstand aus ist absehbar, dass Pretargetingsysteme die antineoplastischen Effekte der RAIT weiter verbessern werden.

Abstract

Convincing findings in recent clinical trials of ⁹⁰Y-Ibritumomab tiuxetan and ¹³¹I-Tositumomab have led to the approval of these substances in the treatment of relapsed follicular NHL (⁹⁰Y-Ibritumomab tiuxetan in Europe and ¹³¹I-Tositumomab in the USA) and in the treatment of refractory low-grade and transformed NHL (¹³¹I-Tositumomab in the USA). Trials have shown that ⁹⁰Y-Ibritumomab tiuxetan and ¹³¹I-Tositumomab, either as single agents or in combination with chemotherapy, are effective in the first-line treatment and consolidation therapy of B-NHL. Treatment with RAIT has also been shown to be effective in patients with aggressive lymphomas, and in high-dose chemotherapy regimens with stem cell rescue, where a high rate of complete and durable remissions could be achieved. First results of fractionated regimens are promising and need further evaluation. Pretargeting strategies will undoubtedly improve the antineoplastic effects of RAIT.

Schlüsselwörter

Radioimmuntherapie(RAIT) - Non-Hodgkin-Lymphom (NHL)

Key words

radioimmunotherapy (RAIT) - Non-Hodgkin Lymphoma (NHL)

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