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Ibritumomab tiuxetan radiolabeled with indium-111 and yttrium-90 is a combination regimen used as part of the Zevalin therapeutic protocol for the treatment of adult patients with relapsed or refractory, low-grade or follicular B-cell non-Hodgkin's lymphoma. Ibritumomab tiuxetan is a murine IgG1 kappa monoclonal antibody that targets the CD20 antigen on B lymphocytes. The drug is conjugated to either indium-111 (for imaging and dosimetry) or yttrium-90 (for therapy). Indium-111-labeled Zevalin allows for imaging and biodistribution assessment prior to administration of the therapeutic dose. Yttrium-90-labeled Zevalin delivers targeted beta radiation to CD20-positive cells, resulting in cell death through direct cytotoxicity and immune-mediated mechanisms. The regimen also includes rituximab pretreatment to deplete circulating B-cells and enhance targeting[1][2][6][7].
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