Abstract
Radiolabeled anti-CD20 monoclonal antibody, 90Y-ibritumomab tiuxetan became available for the treatment of refractory or relapsed low-grade B-cell non-Hodgkin’s lymphoma (NHL). Although FDG-PET is widely used for monitoring the response to chemotherapy and radiotherapy, there are limited data for monitoring the response of NHL to radioimmunotherapy (RIT) with FDG-PET.
Experience in our institute We retrospectively evaluated our experience using FDG-PET/CT for monitoring the response of NHL to RIT. Methods A total of 34 patients received 90Y-ibritumomab tiuxetan and underwent FDG-PET/CT scans before and at 3 months after RIT. Subsequent scans were performed at 7–12 months and at 12–24 months after RIT. PET/CT scans after additional treatment with clinical evidence of relapse after RIT was excluded from analysis; all patients did not receive additional treatment during the evaluating period. Tumor metabolic activity was assessed before and after RIT visually on PET/CT images and compared with the treatment effect and clinical course. Results According to the revised IWC criteria, the maximal response was CR in 22 patients, PR in 5 patients, and PD in 1 patient (1 patient not evaluable). FDG-PET was positive in 10 patients before RIT, 5 patients at 3 months, 5 patients at 7–12 months, and 1 patient at 13 months after RIT. Among 18 patients with negative PET results at 3 months after RIT, only one patient relapsed later. In 2 patients, although PET was positive at 3 months after RIT, abnormal accumulation diminished at 7–9 months after RIT without further treatment.
Conclusions FDG-PET/CT is a useful noninvasive imaging modality for monitoring the response of NHL to RIT. Negative PET finding at 3 months after RIT predicts the treatment effects with high probability. However, positive PET results at 3 months after RIT does not warrant immediate additional therapy because the metabolic response to RIT can be gradual, with continued declines of FDG uptake occurring between 7 and 9 months after RIT without additional therapy.
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- 111In:
-
Indium-111
- FDG:
-
18F-fluorodeoxyglucose
- MALT:
-
Mucosa-associated lymphoid tissue
- PET:
-
Positron emission tomography
- RIT:
-
Radioimmunotherapy
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Ishimori, T., Nakatani, K. (2018). Radiological Evaluation of Response and Resistance of Ibritumomab. In: Hosono, M., Chatal, JF. (eds) Resistance to Ibritumomab in Lymphoma. Resistance to Targeted Anti-Cancer Therapeutics, vol 18. Springer, Cham. https://doi.org/10.1007/978-3-319-78238-6_5
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DOI: https://doi.org/10.1007/978-3-319-78238-6_5
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