Rituximab (Rituxan)
General information
Class/mechanism: Anti-CD20 antibody, chimeric murine/human monoclonal IgG1 kappa, which binds to CD20 (human B-lymphocyte-restricted differentiation antigen, Bp35), which is expressed on B-cells. The Fc domain recruits immune effector functions to mediate B-cell lysis. Possible mechanisms of cell lysis include complement-dependent cytotoxicity (CDC) and antibody-dependent cell mediated cytotoxicity (ADCC).[1][2][3]
Route: IV
Extravasation: no information
For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as Micromedex, Lexicomp, UpToDate (courtesy of Lexicomp), or the prescribing information.[1]
Diseases for which it is used
- Aggressive Non-Hodgkin lymphoma
- Chronic lymphocytic leukemia (CLL) and Small lymphocytic lymphoma (SLL)
- Follicular lymphoma
- HIV-associated lymphoma
- Hodgkin lymphoma
- Hodgkin lymphoma, nodular lymphocyte-predominant
- Mantle cell lymphoma
- Marginal zone lymphoma
- Waldenström macroglobulinemia
Patient drug information
- Rituximab (Rituxan) package insert pages 36-40[1]
- Brief patient counseling information can be found on page 35 of the package insert[1]
- Rituximab (Rituxan) patient drug information (Chemocare)[4]
- Rituximab (Rituxan) patient drug information (UpToDate)[5]
History of changes in FDA indication
- 10/19/2012: FDA approved for 90-minute infusion in previously untreated follicular Non-Hodgkin lymphoma (NHL) and diffuse large B-cell lymphoma (DLBCL) starting with cycle 2:[6]
- Patients who do not experience a grade 3 or 4 infusion related adverse event during cycle 1 may undergo a 90-minute infusion when used as part of a glucocorticoid-containing chemotherapy regimen. In cycle 2, 20% of the total dose is to be given over the first 30 minutes, and the remaining 80% of the total dose is to be given over the last 60 minutes. If this 90-minute infusion is tolerated, the same rate can be used for remaining cycles of the treatment.[1][7][8]
Also known as
Rituxan, Rituxan Chugai, Rituxan Zenyaku
References
- ↑ 1.0 1.1 1.2 1.3 1.4 Rituximab (Rituxan) package insert
- ↑ Rituximab (Rituxan) package insert (locally hosted backup)
- ↑ Rituxan manufacturer's site
- ↑ Rituximab (Rituxan) patient drug information (Chemocare)
- ↑ Rituximab (Rituxan) patient drug information (UpToDate)
- ↑ FDA Approves New Dosing and Administration Information for Rituximab (10/19/2012) Hematology.org, accessed 10/19/2012
- ↑ Atmar J. Review of the safety and feasibility of rapid infusion of rituximab. J Oncol Pract. 2010 Mar;6(2):91-3. link to original article contains verified protocol PubMed
- ↑ Sehn LH, Donaldson J, Filewich A, Fitzgerald C, Gill KK, Runzer N, Searle B, Souliere S, Spinelli JJ, Sutherland J, Connors JM. Rapid infusion rituximab in combination with corticosteroid-containing chemotherapy or as maintenance therapy is well tolerated and can safely be delivered in the community setting. Blood. 2007 May 15;109(10):4171-3. Epub 2007 Jan 23. link to original article contains verified protocol PubMed