Along with Bexxar, Zevalin (ibritumomab tiuxetan) is an important radioimmunotherapy agent which combines an anti-CD20 monoclonal antibody, similar to the better-known rituximab, with a radioactive molecule, yttrium-90. It has been shown to be effective both in relapsed and untreated follicular lymphoma.
Zevalin in Canada: Health Canada approved Zevalin in 2005. However, it contains radioactive agents and can therefore only be used in appropriately controlled settings. Currently, the BC Cancer Agency has authorized Zevalin as third-line treatment for follicular lymphoma. CancerCare Ontario has chosen not to fund Zevalin due to high cost. Other provinces are still reviewing the drug for cost-effectiveness.
How Zevalin Works
Side Effects
Zevalin Monotherapy
Zevalin Consolidation Therapy: Zevalin can also be used as part of a combination treatment. One American study examined first-line R-CHOP followed by Zevalin (consolidation), followed by rituximab (maintenance), in 55 patients. It is difficult to separate out the effect of Zevalin versus the other two components (which are highly effective on their own), but the initial complete remission rate was 89%. Three in five of these patients was still in remission after four years. The study noted that bone marrow involvement was a major factor: 17 of 32 responders with compromised bone marrow relapsed within four years, compared to just 5 of 22 Stage III patients.
Zevalin Combination Therapy
Published Studies
D.R. Mehta et al. "Phase II Study of Short Course CHOP-Rituximab Followed by 90-y Ibritumomab Tiuxetan." Journal of Clinical Oncology (2010).
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