Outpatient radioimmunotherapy with Bexxar†
Closed, clean air reservoir minimizes personnel radiation exposure
Article first published online: 12 FEB 2002
Copyright © 2002 American Cancer Society
Supplement: Eighth Conference on Radioimmunodetection and Radioimmunotherapy of Cancer
Volume 94, Issue Supplement 4, pages 1358–1362, 15 February 2002
How to Cite
Harwood, S. J., Gibbons, L. K., Goldner, P. J., Webster, W. B. and Carroll, R. G. (2002), Outpatient radioimmunotherapy with Bexxar. Cancer, 94: 1358–1362. doi: 10.1002/cncr.10306
published in abstract form in Cancer Biother Radiopharm 2000;15:414.
- Issue published online: 12 FEB 2002
- Article first published online: 12 FEB 2002
- Manuscript Accepted: 14 NOV 2001
- Manuscript Received: 31 OCT 2001
- Corixa Corporation (formerly Coulter Pharmaceutical Incorporated), South San Francisco, CA
- Department of Veterans Affairs, Washington, DC
- monoclonal antibodies;
- non-Hodgkin lymphoma;
- radiation protection;
Radioimmunotherapy (RIT) with Bexxar (tositumomab and iodine-131 tositumomab; Coulter Pharmaceutical, South San Francisco, CA) has been shown to be effective in the treatment of low-grade and transformed low-grade non-Hodgkin lymphoma (NHL).
Patient-specific dosimetry with 5 mCi of iodine-131 tositumomab preceded by 450 mg of tositumomab was utilized to calculate the radionuclide dose needed to deliver 75 cGy whole-body radiation (65 cGy for platelet counts of 100,000–149,000/mm3). To safely infuse the approximately 95 mCi (range, 52–211mCi) of iodine-131 needed for this treatment, a shielded, closed system was developed to minimize radiation exposure for personnel administering the treatment infusions and to eliminate possible release of aerosolized iodine-131.
Twenty-five patients who could be evaluated were infused with a single course of iodine-131 tositumomab therapy and achieved a 76% total response rate at 3 months (32% complete response [CR], 44% partial response [PR]); 59% total response at 6 months (40% CR, 18% PR); and 38% total response at 12 months (31% CR, 6% PR). Administration of RIT using our unique, totally closed system significantly reduced personnel exposure and potential for radioactive spills. The sum of all individuals who administered and monitored the infusions was < 120 mRem whole body exposure over 22 months, well within the ALARA (as low as reasonably achievable) Level I guideline limits. No radioiodide was detectable in the thyroid of any staff member.
In NHL patients who had experienced failure with conventional therapy, RIT with iodine-131 tositumomab therapy was safe and effective. Response rates obtained were equivalent to those obtained at the university medical centers where the Phase I–III clinical trials were performed. Cancer 2002;94:1358–62. © 2002 American Cancer Society.