Radioimmunoconjugates Versus Monoclonal Antibody For Patients With Lymphoma: A Systematic Review

Objective To assess the efficacy and safety of radioimmunoconjugates versus monoclonal antibody (MAb) for non-Hodgkin lymphoma (NHL).Method We searched Cochrane Library (2008 issue 2), PubMed (1966-2008.6), EMBASE (1974-2008.6), Chinese Biomedical Literature Database (1978-2008.6), Chinese Scientific Journals Fulltext Database (1989-2008.6), China Journal Fulltext Database (1994-2008.6) and handsearched some related Chinese Journals. Randomized controlled trials comparing RIT and MAb for NHL patients were included. The quality of included studies was assessed according to criteria recommended by The Cochrane Handbook for Systematic Reviews 5.0 and meta-analyses were performed for homogeneous studies by The Cochrane Collaboration's RevMan 5.0.Results 2 RCTs involving 221 patients (RIT/MAb: 115/106) met the inclusion criteria. The results of meta-analysis were listed as follows:â‘ RIT was superior to MAb on overall response rate [OR=3.64,95%CI(2.01,6.62)].Subgroup analysis was performed by different types of radioimmunocoiugate, the overall response rate of Zevalin[OR=3.07,95%CI(1.47,6.43)] and Bexxar[OR=5.02,95%CI(1.80,13.98)] were higher than MAb. There was no difference in survival rate [OR=0.85,95%CI(0.34,2.11)]. Meta-analyses were not conducted for median duration of response and time to progression, because the relevant data were not available for the included trials.â‘¡There were higher incidents of nausea [OR=3.64,95%CI(1.96,6.75)], infection [OR=2.66,95%CI(1.11,6.39)], Gradeâ…¢/â…£toxicity of ANC [OR=5.50,95%CI(1.43,21.11)] Gradeâ…¢/â…£toxicity of PLT [OR=37.14,95%CI(2.12,649.47)], There were no difference between the two groups with regard to chills [OR=0.95,95%CI(0.51,1.75)],fever[OR=1.37,95%CI(0.71,2.62)],asthenia[OR=1.27,95%CI(0.74,2.17)],pain[OR=1.06,95%CI(0.55,2.04)].Conclusion Current clinical trials might confirm that the overall response rate of RIT was superior to MAb, but the incidences of adverse effects were higher. Because of all kinds of bias, we still need more high-quality and long-term follow-up clinical trials to confirm the results.