放射性核素标记抗CD20单克隆抗体治疗B细胞淋巴瘤的研究进展

Advances in research of radioactive nuclide labeled anti-CD20 monoclonal antibody in B cell lymphomas

  • 摘要: 放射免疫治疗(radioimmunotherapy,RIT)属于内照射治疗,可以用较少的单克隆抗体耦联放射性核素,在肿瘤局部产生足够的电离辐射生物学效应,达到高效低毒的治疗效果。B细胞淋巴瘤有较高的复发比例,其CD20抗原表达率达90%以上,且不易从细胞膜上脱落,因此131I-利妥昔单抗CD20是B细胞淋巴瘤放免治疗的最佳靶点。目前已有数个放免治疗的药物,如:131I-托西莫单抗(131I-tositumomab)、131I-Rituximab、90Y-替坦异贝莫单抗(90Y-ibritumomabtiuxetan)等,用于B细胞淋巴瘤的临床治疗,它们具有各自的优缺点。使用结果表明:肿瘤部位的高吸收剂量保证了治疗的有效性,其对非靶器官的照射剂量是安全的。最主要的副反应包括:血小板减少症、中性粒细胞减少症、胃肠道反应及甲状腺功能减低症。在取得满意结果的同时,B细胞淋巴瘤放免治疗仍存在许多问题,人们正致力于更进一步的研究解决此类问题,以取得更好的治疗效果。

     

    Abstract: Radioimmunotherapy(RIT), a kind of internal radiation therapy, can achieve high performance and low toxicity by fewer monoclonal antibodys couple radioactive nuclides, created sufficient ionization biologic effect on tumor. B cell lymphomas has higher relapsed rate, CD20 is the best target of RIT on B cell lymphomas because the expression rate of it on B cell lymphomas is above 90%, and it is not desquamated easily. There are severy drug of RIT, such as 131I-tositumomab, 131I-Rituximab, and 90Y-ibritumomab tiuxetan. Each one has its advantages and disadvantages. Clinical trials indicates they are effective on B cell lymphomas, and safe to non-targetted organs. The main side effects include thrombopenia, neutropenia, gastrointestinal tract response, and hypothyroidism. While satisfied results have attained, many problems are existed. All researchers do their best to resolve there problems for better therapy results.

     

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