Zevalin Update

Interesting research on Zevalin, the RadioImmunoTherapy (or RIT) treatment. "Real world" data shows that it works well, with good response and survival numbers. The research was presented at the 2020 American Society of Clinical Oncology and Society for Immunotherapy of Cancer Clinical Immuno-Oncology Symposium in February.

The "real world" data means that this research was not part of a clinical trial. Instead, the researchers looked at the records of 171 Non-Hodgkin's Lymphoma patients (107 of them with Follicular Lymphoma) who had been given Zevalin between 2005 and 2017.

As a reminder: Zevalin is a kind of RIT. Basically, RIT is a type of treatment that target cancer cells, the way something like Rituxan does, but grabbing on to a protein on the surface of the cancer cell. But RIT also adds a little bit of radiation to that Rituxan, so the radiation can be delivered right to the cell. Traditional radiation doesn't work as well on lymphoma because the blood cells are always moving, making it hard to hit them with a beam. RIT is a way to deliver the radiation right to the cell. 

In this study, 73 patients achieved a Complete Response from the Zevalin, and 23 had a partial response, for a 70% Overall Response. The median Progression Free Survival (PFS) was 31 months. Not bad for a group that had a median of two prior chemotherapies.

Zevalin has been around for a long time, and has been very effective for a lot of patients. Data presented at the ASH conference last December showed how successful Zevalin was as a long-term treatment. In a study of 137 patients with Follicular Lymphoma who had a Zevalin treatment, patients who had it as their first treatment had a 100% Overall Response Rate, and a 93% Complete Response Rate. For patients who had Zevalin as a second or later treatment, the OR was 93%, and the CR was 73%.

So why isn't RIT used more often?

Well, in the United States, there are particular rules about who is allowed to administer RIT. The amount of training required means that only a small number of Radiation specialists will qualify 9or want to). If oncologists and hematologists, the doctors we typically go to, are not able to administer it, then they likely will look to other treatments when figuring out what to recommend. As FL patients, we are fortunate to have lots of  choices, and most oncologists will go with those choices. And because it's not used often, there's a chance that some oncologists don't fully understand it, or misunderstand the risks involved. Lymphomation.org has a very good section on RadioImmunoTherapy, including some great reading on why it is not used as much as it should be.)

There is an RIT treatment that has been Fast-Tracked by the FDA, called Betalutin. It is still in trials, though if the company that makes it is still excited about it being approved, then I have to think they also have a strategy for getting it understood and recommended by oncologists. I sure hope so.

I've known a few people who had RIT and continue to have very good long-term results, so I've been fascinated with it for a long time. Perhaps the day will come soon when we see a change in attitude toward it, and more use of it.