Logistics of Radioimmunotherapy with Yttrium 90 Ibritumomab Tiuxetan (Zevalin)

Radioimmunotherapy is a promising new therapeutic option for the treatment of B-cell non-Hodgkin's lymphoma. Several monoclonal antibody and radionuclide conjugates, including 1-131 tositumomab and Y-90 ibritumomab, have been investigated in clinical trials. Yttrium 90 ibritumomab tiuxetan (Zevalin; Biogen Idec Inc, Cambridge, MA) is indicated for the treatment of patients with relapsed or refractory low-grade, follicular, or transformed B-cell non-Hodgkin's lymphoma, including patients with rituximab-refractory follicular non-Hodgkin's lymphoma. The ibritumomab tiuxetan regimen requires coordination of a multidisciplinary team on which the nuclear medicine physician (or radiation oncologist) plays a major role. The nuclear medicine physician (or radiation oncologist) is responsible for overseeing the administration of the radioimmunoconjugates and for interpreting the imaging scans to determine the expected or altered biodistribution of the radioimmunoconjugate.