In a healthy immune system, certain white cells are able to recognize invading organisms such as bacteria and viruses. The white cell secretes a protein substance called an antibody that identifies a feature of the foreign cell called an antigen. The antibody coats the invading cell, which enables other white cells to destroy it.
In immunotherapy, scientists create monoclonal antibodies in a laboratory that are designed to recognize and bind to the antigen of a specific cancer cell.
In RIT, the monoclonal antibody is paired with a radioactive material. When injected into the patient’s bloodstream, the antibody travels to and binds to the cancer cells, allowing a high dose of radiation to be delivered directly to the tumor.
RIT is used to treat a variety of cancers, most commonly lymphoma. Several new RIT agents to treat other cancers are under development or in clinical trials.
Frequently Asked Questions (FAQ) for Patients – WITH ANSWERS!
Q: How does RIT work?
A: RIT involves the use of small particles (antibodies) that target specific receptors expressed on the surface of lymphoma cells. These antibodies have radioactive substances (iodine 131 or yttrium 90) attached to them. This targeted radiation kills the lymphoma cells.
Q: How do I prepare for treatment with RIT?
A: You will have to follow the instructions from your treating physician, including follow-up for laboratory data.
Q: Where will I go to receive the imaging dose? The therapeutic dose?
A: Your treating physician will instruct you where to present for the infusion of rituximab that is given before the imaging and the therapeutic doses. Both the imaging and therapeutic doses are given in the Nuclear Medicine clinic
Q: How is the medication given?
A: The medication is given as a slow (20 minutes) intravenous infusion
Q: What kind of side effects should I expect?
A: The most common side effects include decreased blood counts, fatigue, stomach pain, nausea, weakness, diarrhea, cough, fever, and nose and upper throat irritation.
Q: What kind of follow-up is needed after completing the regimen?
A: You will have to follow-up with your Oncologist to measure the level of blood cells at 4-6 weeks after treatment to identify any reduction in red blood cells, white blood cells or platelets.
Q: Do I need to take special safety precautions after receiving RIT?
A: Your treating Nuclear Medicine physician will give you specific precautions immediately after treatment with Zevalin, but the goal of all these is to minimize radiation exposure to others. Therefore, due diligence is required on your part to avoid crowded places, reduce time and increase distance to others for several day after treatment. You should not come in contact with small children and pregnant women.
Myths about RIT
There are four primary myths that surrounds RIT:
- RIT precludes future treatments if necessary
- RIT causes secondary cancers
- There is not enough data to support RIT
- Other treatments work “just as well”
Betsy de Parry– received RIT in 2002 in remission since
In January 2002, I heard the words that threatened to steal my future: follicular non-Hodgkin lymphoma, stage IV. I soon began treatment with CVP, but my disease progressed, and CVP was quickly replaced by R-CHOP. Again, my disease raged on and treatment had to be stopped half way through. RIT came next, in September 2002. Not only was taking it infinitely easier than chemotherapy – no hair loss, no side effects, and finished in one week – but it also yielded far better results: RIT successfully stopped the disease that had seemed so determined to stop me, and I’ve been healthy since, without further treatment.
RIT gave me the chance to live and love and laugh after lymphoma – which is exactly what my husband and I have been very busy doing. Every day, we’re so grateful that RIT was available and that my doctor prescribed it for me. That combination gave us back our future.
Teresa Singh– received RIT 1996 in remission since
Back in 1996, before the Internet was so widely available to everyone, I got a jolting diagnosis: non-Hodgkins lymphoma. Medical books I consulted in the library were not encouraging. During my first consultation with an oncologist, I was told about a clinical trial being conducted in my home town of Ann Arbor, Michigan. If I “passed” the requirements, I could be considered for this recently opened trial to “first line” patients: a form of radioimmunotherapy. I took the chance and entered the trial headed by Dr. Mark Kaminski and Dr. Richard Wahl, then both at the University of Michigan. I received treatment in September 1996. I’ve had no relapses since. I’ve participated in other studies to test how the RIT (now called “Bexxar”*) influences bone marrow and the immune systems. The low white blood cell count I experienced lasted about a year. My thyroid gland stopped functioning, but I consider these minor side-effects compared to the longer, healthier life I’ve been gifted. And not everyone has the thyroid complication. I have continued to live a full, enriched life working and raising a family and feeling strong, blessed and grateful for the exceptional timing of my diagnosis and Dr. Kaminski’s amazing discovery. I only hope that others can find the good fortune that found me.
*The RIT with the commercial name "Bexxar" is no longer available.
Jan Waters– received RIT 2004 in remission since
“I owe my life to RIT and I want other people to have a chance to put cancer away on the back burner and have a life!”