Does tumoral (111)In-ibritumomab accumulation correlate with therapeutic effect and outcome in relapsed or refractory low-grade B-cell lymphoma patients undergoing (90)Y-ibritumomab radioimmunotherapy?

Eur Radiol. 2014 Dec;24(12):3191-8. doi: 10.1007/s00330-014-3378-4. Epub 2014 Aug 12.

Abstract

Objectives: The aim of this study was to determine whether tumoral (111)In-ibritumomab accumulation on pre-treatment imaging correlates with therapeutic responses and progression-free survival (PFS) in patients with non-Hodgkin's lymphoma (NHL) undergoing (90)Y-ibritumomab radioimmunotherapy (RIT).

Methods: This was a retrospective study of 39 patients with low-grade B-cell NHL treated with RIT. We classified the patients into positive and negative groups according to the presence or absence of tumoral (111)In-ibritumomab accumulation on pre-treatment (111)In-ibritumomab examinations. We then determined the correlation between the (111)In-ibritumomab imaging findings and the patients' therapeutic responses and PFS.

Results: Tumoral (111)In-ibritumomab accumulation was positive in 64.1% and negative in 35.9% of the patients. The (111)In-positive patients had a significantly higher overall response rate (ORR) compared to the (111)In-negative patients (100.0% vs. 78.6%, p = 0.02). The (111)In-negative patients with advanced disease (stages III/IV) had a significantly lower ORR (40%) and a significantly higher rate of progressive disease (40.0%) compared to those of the (111)In-negative patients with limited disease (stages I/II) (100% and 0%, p = 0.009 each). However, these two groups had similar 2-year PFS rates (65.0% vs. 50.0%, p = 0.80).

Conclusions: (111)In-ibritumomab imaging findings seem to correlate with ORR and the progressive disease rate after RIT, but not with PFS.

Key points: All 39 NHL patients had tumoral accumulation on pretreatment FDG-PET/CT. 64.1% of NHL patients had tumoral accumulation on a pretreatment (111) In-ibritumomab examination. (90) Y-ibritumomab RIT resulted in high overall response and complete remission rates. (111) In-ibritumomab avidity of lymphoma lesions could predict a strong therapeutic effect. (111) In-ibritumomab imaging findings did not correlate with progression-free survival.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Monoclonal / therapeutic use*
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Humans
  • Indium Radioisotopes / pharmacokinetics*
  • Lymphoma, B-Cell / diagnostic imaging
  • Lymphoma, B-Cell / radiotherapy*
  • Male
  • Middle Aged
  • Positron-Emission Tomography / methods*
  • Radioimmunotherapy / methods*
  • Remission Induction
  • Retrospective Studies
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal
  • Indium Radioisotopes
  • ibritumomab tiuxetan