Radioimmunotherapy with Yttrium 90 ibritumomab tiuxetan (Zevalin): the role of the nuclear medicine physician

Abstract

Radioimmunotherapy is an emerging clinical treatment option for non-Hodgkin’s lymphoma (NHL) that combines the target specificity of monoclonal antibodies with the cytotoxicity of targeted radiation, thereby avoiding the toxicity to normal organs associated with external beam radiotherapy. Yttrium 90 ibritumomab tiuxetan (Zevalin: Biogen Idec Inc, Cambridge, MA), the first radioimmunotherapeutic agent approved by the US Food and Drug Administration for the treatment of cancer, is indicated for the treatment of patients with relapsed or refractory low-grade, follicular, or transformed B-cell NHL, including patients with rituximab-refractory follicular NHL. It is likely that radioimmunotherapy will become a more common treatment option in NHL, necessitating the participation of nuclear medicine physicians on radioimmunotherapy treatment teams. The nuclear medicine physician plays a major role on the multidisciplinary treatment team, and is responsible for overseeing the administration of the radioimmunoconjugates and for interpreting the imaging scans to determine the biodistribution of the radioimmunoconjugate. It is important that nuclear medicine physicians be familiar with their role in administering radioimmunotherapy, the efficacy and safety of this treatment, and its logistics and radiation safety issues.