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Radioimmunotherapy
Radioimmunotherapy (RIT) uses an antibody labeled with a radionuclide to deliver cytotoxic radiation to a target cell. It is a form of unsealed source radiotherapy. In cancer therapy, an antibody with specificity for a tumor-associated antigen is used to deliver a lethal dose of radiation to the tumor cells. The ability for the antibody to specifically bind to a tumor-associated antigen increases the dose delivered to the tumor cells while decreasing the dose to normal tissues. By its nature, RIT requires a tumor cell to express an antigen that is unique to the neoplasm or is not accessible in normal cells. History of available agents 131I tositumomab and 90Y ibritumomab tiuxetan were the first agents of radioimmunotherapy, and they were approved for the treatment of refractory non-Hodgkin's lymphoma. This means they are used in patients whose lymphoma is refractory to conventional chemotherapy and the monoclonal antibody rituximab. Agents in clinical development A set ...
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Ibritumomab Tiuxetan
Ibritumomab tiuxetan (pronounced ), sold under the trade name Zevalin, is a monoclonal antibody radioimmunotherapy treatment for non-Hodgkin's lymphoma. The drug uses the monoclonal mouse IgG1 antibody ibritumomab in conjunction with the chelator tiuxetan, to which a radioactive isotope (either yttrium-90 or indium-111) is added. Tiuxetan is a modified version of DTPA whose carbon backbone contains an isothiocyanatobenzyl and a methyl group. Medical use Ibritumomab tiuxetan is used to treat relapsed or refractory, low grade or transformed B cell non-Hodgkin's lymphoma (NHL), a lymphoproliferative disorder, and previously untreated follicular NHL in adults who achieve a partial or complete response to first-line chemotherapy. The treatment starts with an infusion of rituximab. This may be followed by an administration of indium-111 labeled ibritumomab tiuxetan (111In replaces the 90Y component) to allow the distribution of the medication to be imaged on a gamma camera, befo ...
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Yttrium-90
Yttrium-90 () is a radioactive isotope of yttrium. Yttrium-90 has found a wide range of uses in radiation therapy to treat some forms of cancer Cancer is a group of diseases involving Cell growth#Disorders, abnormal cell growth with the potential to Invasion (cancer), invade or Metastasis, spread to other parts of the body. These contrast with benign tumors, which do not spread. Po .... Along with other isotopes of yttrium, it is sometimes called radioyttrium. Decay undergoes beta particles emissions/decay (beta decay, β− decay) to zirconium-90 with a half-life of 64.1 hours and a decay energy of 2.28 MeV with an average beta energy of 0.9336 MeV. It also produces 0.01% 1.7 MeV photons during its decay process to the 0+ state of 90Zr, followed by pair production. The interaction between emitted electrons and matter can lead to the emission of Bremsstrahlung radiation. Production Yttrium-90 is produced by the nuclear decay of strontium-90 which has a half-l ...
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Antibody
An antibody (Ab) or immunoglobulin (Ig) is a large, Y-shaped protein belonging to the immunoglobulin superfamily which is used by the immune system to identify and neutralize antigens such as pathogenic bacteria, bacteria and viruses, including those that cause disease. Each individual antibody recognizes one or more specific antigens, and antigens of virtually any size and chemical composition can be recognized. Antigen literally means "antibody generator", as it is the presence of an antigen that drives the formation of an antigen-specific antibody. Each of the branching chains comprising the "Y" of an antibody contains a paratope that specifically binds to one particular epitope on an antigen, allowing the two molecules to bind together with precision. Using this mechanism, antibodies can effectively "tag" the antigen (or a microbe or an infected cell bearing such an antigen) for attack by cells of the immune system, or can neutralize it directly (for example, by blocking a p ...
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Iodine-131
Iodine-131 (131I, I-131) is an important radioisotope of iodine discovered by Glenn Seaborg and John Livingood in 1938 at the University of California, Berkeley. It has a radioactive decay half-life of about eight days. It is associated with nuclear energy, medical diagnostic and treatment procedures, and natural gas production. It also plays a major role as a radioactive isotope present in nuclear fission products, and was a significant contributor to the health hazards from open-air atomic bomb testing in the 1950s, and from the Chernobyl disaster, as well as being a large fraction of the contamination hazard in the first weeks in the Fukushima nuclear crisis. This is because 131I is a major fission product of uranium and plutonium, comprising nearly 3% of the total products of fission (by weight). See fission product yield for a comparison with other radioactive fission products. 131I is also a major fission product of uranium-233, produced from thorium. Due to its mode of ...
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Beta Emitter
In nuclear physics, beta decay (β-decay) is a type of radioactive decay in which an atomic nucleus emits a beta particle (fast energetic electron or positron), transforming into an isobar of that nuclide. For example, beta decay of a neutron transforms it into a proton by the emission of an electron accompanied by an antineutrino; or, conversely a proton is converted into a neutron by the emission of a positron with a neutrino in what is called ''positron emission''. Neither the beta particle nor its associated (anti-)neutrino exist within the nucleus prior to beta decay, but are created in the decay process. By this process, unstable atoms obtain a more stable ratio of protons to neutrons. The probability of a nuclide decaying due to beta and other forms of decay is determined by its nuclear binding energy. The binding energies of all existing nuclides form what is called the nuclear band or valley of stability. For either electron or positron emission to be energetically pos ...
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Actinium-225
Actinium-225 (225Ac, Ac-225) is an isotope of actinium. It undergoes alpha decay to francium-221 with a half-life of 10 days, and is an intermediate decay product in the neptunium series (the decay chain starting at neptunium-237, 237Np). Except for minuscule quantities arising from this decay chain in nature, 225Ac is entirely synthetic radioisotope, synthetic. The decay properties of actinium-225 are favorable for usage in targeted alpha-particle therapy, targeted alpha therapy (TAT); clinical trials have demonstrated the applicability of radiopharmaceuticals containing 225Ac to treat various types of cancer. However, the scarcity of this isotope resulting from its necessary synthesis in cyclotrons limits its potential applications. Decay and occurrence Actinium-225 has a half-life of 10 days and decays by alpha particle, alpha emission. It is part of the neptunium series, for it arises as a decay product of neptunium-237 and its daughter nuclide, daughters such as uraniu ...
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Bismuth-213
Bismuth (83Bi) has 41 known isotopes, ranging from 184Bi to 224Bi. Bismuth has no stable isotopes, but does have one very long-lived isotope; thus, the standard atomic weight can be given as . Although bismuth-209 is now known to be radioactive, it has classically been considered to be a stable isotope because it has a half-life of approximately 2.01×1019 years, which is more than a billion times the age of the universe. Besides 209Bi, the most stable bismuth radioisotopes are 210mBi with a half-life of 3.04 million years, 208Bi with a half-life of 368,000 years and 207Bi, with a half-life of 32.9 years, none of which occur in nature. All other isotopes have half-lives under 1 year, most under a day. Of naturally occurring radioisotopes, the most stable is radiogenic 210Bi with a half-life of 5.012 days. 210mBi is unusual for being a nuclear isomer with a half-life multiple orders of magnitude longer than that of the ground state. List of isotopes , -id=Bismuth-184 , 184Bi ...
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Alpha Emitter
Alpha particles, also called alpha rays or alpha radiation, consist of two protons and two neutrons bound together into a particle identical to a helium-4 nucleus. They are generally produced in the process of alpha decay but may also be produced in different ways. Alpha particles are named after the first letter in the Greek alphabet, α. The symbol for the alpha particle is α or α2+. Because they are identical to helium nuclei, they are also sometimes written as He2+ or 2+ indicating a helium ion with a +2 charge (missing its two electrons). Once the ion gains electrons from its environment, the alpha particle becomes a normal (electrically neutral) helium atom . Alpha particles have a net spin of zero. When produced in standard alpha radioactive decay, alpha particles generally have a kinetic energy of about 5 MeV and a velocity in the vicinity of 4% of the speed of light. They are a highly ionizing form of particle radiation, with low penetration depth (stopped by a f ...
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Rituximab
Rituximab, sold under the brand name Rituxan among others, is a monoclonal antibody medication used to treat certain autoimmune diseases and types of cancer. It is used for non-Hodgkin lymphoma, chronic lymphocytic leukemia (in children and adults, but not recommended in elderly patients), rheumatoid arthritis, granulomatosis with polyangiitis, idiopathic thrombocytopenic purpura, pemphigus vulgaris, myasthenia gravis and Epstein–Barr virus-positive mucocutaneous ulcers. It is given by slow intravenous infusion (injected slowly through an IV line). The most common side effects with intravenous infusions are reactions related to the infusion (such as fever, chills and shivering) while most common serious side effects are infusion reactions, infections and heart-related problems. Similar side effects are seen when it is injected under the skin, with the exception of reactions around the injections site (pain, swelling and rash), which occur more frequently with the skin inject ...
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Chemotherapy
Chemotherapy (often abbreviated chemo, sometimes CTX and CTx) is the type of cancer treatment that uses one or more anti-cancer drugs (list of chemotherapeutic agents, chemotherapeutic agents or alkylating agents) in a standard chemotherapy regimen, regimen. Chemotherapy may be given with a cure, curative intent (which almost always involves combinations of drugs), or it may aim only to prolong life or to Palliative care, reduce symptoms (Palliative care, palliative chemotherapy). Chemotherapy is one of the major categories of the medical discipline specifically devoted to pharmacotherapy for cancer, which is called ''oncology#Specialties, medical oncology''. The term ''chemotherapy'' now means the non-specific use of intracellular poisons to inhibit mitosis (cell division) or to induce DNA damage (naturally occurring), DNA damage (so that DNA repair can augment chemotherapy). This meaning excludes the more-selective agents that block extracellular signals (signal transduction) ...
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Non-Hodgkin's Lymphoma
Non-Hodgkin lymphoma (NHL), also known as non-Hodgkin's lymphoma, is a group of blood cancers that includes all types of lymphomas except Hodgkin lymphomas. Symptoms include enlarged lymph nodes, fever, night sweats, weight loss, and tiredness. Other symptoms may include bone pain, chest pain, or itchiness. Some forms are slow-growing while others are fast-growing. Unlike Hodgkin lymphoma, which spreads contiguously, NHL is largely a systemic illness. Signs and symptoms The signs and symptoms of non-Hodgkin lymphoma vary depending upon its location within the body. Symptoms include enlarged lymph nodes, fever, night sweats, weight loss, and tiredness. Other symptoms may include bone pain, chest pain, or itchiness. Some forms are slow growing, while others are fast growing. Enlarged lymph nodes may cause lumps to be felt under the skin when they are close to the surface of the body. Lymphomas in the skin may also result in lumps, which are commonly itchy, red, or purple ...
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Fast Track (FDA)
Fast track is a designation by the United States Food and Drug Administration (FDA) of an investigational drug for expedited review to facilitate development of drugs that treat a serious or life-threatening condition and fill an unmet medical need. Fast track designation must be requested by the drug company. The request can be initiated at any time during the drug development process. FDA will review the request and attempt to make a decision within sixty days. Purpose Fast track is one of five FDA approaches to make new drugs available as rapidly as possible: the others are priority review, breakthrough therapy, accelerated approval and regenerative medicine advanced therapy. Fast track was introduced by the FDA Modernization Act of 1997. Requirements Fast track designation is designed to aid in the development and expedite the review of drugs which show promise in treating a serious or life-threatening disease and address an unmet medical need. Serious condition: det ...
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