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| Monoclonal antibody | |
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| Type | Whole antibody |
| Source | Mouse |
| Target | CD20 |
| Clinical data | |
| Trade names | Zevalin |
| AHFS/Drugs.com | Monograph |
| License data | |
| Routes of administration | Intravenous |
| ATC code | |
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| Legal status | |
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| DrugBank |
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 N Y (what is this?) (verify) | |
Ibritumomab tiuxetan (pronounced/ɪbrɪˈtuːmoʊmæbtaɪˈʌksɛtæn/[2]), sold under the trade nameZevalin, is amonoclonal antibodyradioimmunotherapy treatment fornon-Hodgkin's lymphoma. The drug uses the monoclonal mouseIgG1antibody ibritumomab in conjunction with thechelator tiuxetan, to which a radioactive isotope (eitheryttrium-90 orindium-111) is added. Tiuxetan is a modified version ofDTPA whose carbon backbone contains an isothiocyanatobenzyl and amethyl group.[3][4]
Ibritumomab tiuxetan is used to treat relapsed or refractory, low grade or transformedB cellnon-Hodgkin's lymphoma (NHL), alymphoproliferative disorder, and previously untreatedfollicular NHL in adults who achieve a partial or complete response tofirst-linechemotherapy.[5]
The treatment starts with an infusion ofrituximab. This may be followed by an administration ofindium-111 labeled ibritumomab tiuxetan (111In replaces the90Y component) to allow the distribution of the medication to be imaged on agamma camera, before the actual therapy is administered.[6]
The antibody binds to theCD20antigen found on the surface of normal and malignantB cells (but not B cell precursors), allowing radiation from the attachedisotope (mostlybeta emission) to kill it and some nearby cells. In addition, the antibody itself may trigger cell death viaantibody-dependent cell-mediated cytotoxicity (ADCC),complement-dependent cytotoxicity (CDC), andapoptosis. Together, these actions eliminate B cells from the body, allowing a new population of healthy B cells to develop fromlymphoidstem cells.[7]
Developed by IDEC Pharmaceuticals, now part ofBiogen Idec,[8] ibritumomab tiuxetan was the first radioimmunotherapy drug approved by the USFood and Drug Administration (FDA) in 2002 to treat cancer. It was approved for the treatment of people with relapsed or refractory, low‑grade or follicular B‑cell non‑Hodgkin's lymphoma (NHL), including people with rituximab refractory follicular NHL.[9] It was givenmarketing authorization by theEuropean Medicines Agency in 2004 for the treatment of adults with rituximab relapsed orrefractory CD20+ follicular B-cell non-Hodgkin's lymphoma but.[1] The authorization lapsed in July 2024, after it wasn't marketed for more than three consecutive years.[1]
In September 2009, ibritumomab tiuxetan received approval from the FDA for an expanded label to include previously untreated people with a chemotherapy response.[5]
Ibritumomab tiuxetan is under patent protection and not available ingeneric form. When approved, it was the most expensive medication available given in a single dose, costing overUS$37,000 (€30,000) for the average dose.[10][11] Compared with other monoclonal antibody treatments (many of which are well over $40,000 for a course of therapy), it may be considered cost effective.[10][12]
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