SNMMI: Radioimmunotherapy + chemo boosts survival for lymphoma patients

Combining radioimmunotherapy (RIT) with chemotherapy can significantly improve chance of survival for patients with recurrent lymphoma compared with chemotherapy alone, according to a study presented at the Society of Nuclear Medicine and Molecular Imaging’s 2013 annual meeting in Vancouver.

Prognosis varied by circumstance, but the new treatment protocol was shown to have up to a 100 percent chance of survival in certain patients at two-year follow-up, according to S. Tzila Zwas, MD, of Sackler School of Medicine, Tel-Aviv University, and Sheba Medical Center in Ramat Gan, Israel, and colleagues.

Current treatment standard for patients with recurrent lymphoma is the administration of high-dose chemotherapy called BEAM followed by bone marrow transplantation. BEAM consists of carmustine, etoposide, cytarabine and melphalan.

Zwas and colleagues conducted a two-part multicenter prospective study to compare standard BEAM treatments with Z-BEAM, a treatment combining BEAM and RIT with the radionuclide Zevalin. A total of 43 patients with remaining or relapsed lymphoma were randomized to receive one of the two treatments prior to bone marrow transplant.

Results showed that patients who received Z-BEAM had a 64 percent chance of survival, compared with a 43 percent chance for patients undergoing BEAM chemotherapy alone. In patients without limiting factors—such as advanced age, high-risk disease and positive pre-transplant PET/CT scans—and who received Z-BEAM, odds of survival were 100 percent at two years, according to Zwas and colleagues.

“Zevalin with [high-dose] BEAM chemotherapy is safe and seems more effective than BEAM alone as conditioning regimen for [bone marrow transplant],” wrote the authors in the study abstract. “However, larger studies with longer follow-up are warranted to accept it as a new standard of care for [bone marrow transplant].”