A phase 1 trial of 90Y-Zevalin radioimmunotherapy with autologous stem cell transplant for multiple myeloma

Angela Dispenzieri, A. D'Souza, Morie Gertz, K. Laumann, G. Wiseman, Martha Lacy, B. LaPlant, F. Buadi, S. R. Hayman, Shaji K Kumar, David M Dingli, William Hogan, Stephen Maxted Ansell, D. A. Gastineau, D. J. Inwards, Ivana Micallef, L. F. Porrata, Patrick Bruce Johnston, Mark R Litzow, Thomas Elmer Witzig

Research output: Contribution to journalArticle

Abstract

This phase 1 study (clinical trial NCT00477815) was conducted to determine the maximum tolerated dose (MTD) of yttrium-90 ibritumomab tiuxetan (90Y-Zevalin) with high dose melphalan (HDM) therapy in multiple myeloma (MM) patients undergoing autologous stem cell transplantation (ASCT). In a 3+3 trial design, 30 patients received rituximab 250 mg/m2 with indium-111 ibritumomab tiuxetan (111In-Zevalin) for dosimetry (day -22); rituximab 250 mg/m2 with escalating doses of 90Y-Zevalin (day -14); melphalan 100 mg/m2 (days -2,-1) followed by ASCT (day 0) and sargramostim (GM-CSF, day 0) until neutrophil engraftment. Each patient's 111In-Zevalin dosimetry data were used to calculate the dose of 90Y-Zevalin (in mCi) to deliver 10, 12, 14, 16, 18 or 20 Gy to the liver. Dose limiting toxicities were seen in 3 patients. The overall response rate was 73% (22/30) with stringent complete response in 2 patients; complete response, 5; very good partial response, 12; and partial response, 3. The median PFS was 16.5 months and the median overall survival was 63.4 months. In MM, the MTD of 90Y-Zevalin with HDM is 18 Gy to the liver. The addition of radiation with novel delivery methods such as radioimmunotherapy combined with standard transplant regimens warrants further study.

Original languageEnglish (US)
Pages (from-to)1372-1377
Number of pages6
JournalBone Marrow Transplantation
Volume52
Issue number10
DOIs
StatePublished - Oct 1 2017

    Fingerprint

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this