TREATMENT OF NON-HODGKIN LYMPHOMA USING LILOTOMAB AND 177LU-LILOTOMAB SATETRAXETAN
20220160907 · 2022-05-26
Inventors
Cpc classification
A61K51/1027
HUMAN NECESSITIES
C07K16/2896
CHEMISTRY; METALLURGY
A61K51/1096
HUMAN NECESSITIES
A61K2039/545
HUMAN NECESSITIES
A61K51/1069
HUMAN NECESSITIES
A61K2039/507
HUMAN NECESSITIES
A61P35/00
HUMAN NECESSITIES
International classification
A61K51/10
HUMAN NECESSITIES
A61P35/00
HUMAN NECESSITIES
C07K16/28
CHEMISTRY; METALLURGY
Abstract
The disclosure relates to the use of .sup.177Lu-lilotomab satetraxetan in the treatment of Non-Hodgkin lymphoma. Aspects included are specific administration patterns, with specific concentrations, pre-treatments and predosing.
Claims
1. (canceled)
2. A method of inhibiting Diffuse Large B-cell lymphoma (DLBCL), the method comprising: administering .sup.177Lu-lilotomab satetraxetan to a person in need thereof as follows: a) pretreatment of said person with 375 mg/m.sup.2 rituximab administered at 14 days before administration of .sup.177Lu-lilotomab satetraxetan, and b) predosing of said person with 100-250 mg/m.sup.2 lilotomab less than 4 hours before administration of .sup.177Lu-lilotomab satetraxetan, followed by c) dosing of said person with 20-45 MBq/kg .sup.177Lu-lilotomab satetraxetan.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
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DETAILED DESCRIPTION
[0053] The present invention relates to the treatment of Non-Hodgkin lymphoma using .sup.177Lu-lilotomab satetraxetan with lilotomab and with or without rituximab, where the inventors surprisingly have found that a specific treatment pattern have advantageous effects.
[0054] An aspect of the present invention relates to .sup.177Lu-lilotomab satetraxetan for use in the treatment of Non-Hodgkin lymphoma or other CD37 positive blood cancers, wherein .sup.177Lu-lilotomab satetraxetan is administered according to a clinically relevant administration pattern comprising 10-20 MBq/kg .sup.177Lu-lilotomab satetraxetan, to a person in need thereof.
[0055] The clinically relevant administration pattern can be seen as an administration pattern that has clinical relevance and effect on human individuals suffering from Non-Hodgkin lymphoma.
[0056] A further aspect of the present invention relates to .sup.177Lu-lilotomab satetraxetan for use in the treatment of Non-Hodgkin lymphoma, wherein .sup.177Lu-lilotomab satetraxetan is administered according to an administration pattern comprising: a) predosing of 20-100 mg/m.sup.2 lilotomab, followed by b) 10-20 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0057] In the present context can the term treatment be seen as the partial of full treatment of cancer, including any amelioration and for example stabilization of progressing disease.
[0058] Thus, the term treatment may be seen as an improvement of any of the criteria tested in the examples of the present disclosure. One criteria is overall response rate (ORR). Another is complete response (CR). A further is partial response (PR). Another is stable disease (SD).
[0059] The lilotomab predosing effect is likely caused by blocking of the binding on remaining B-cells in the lymphoid organs. This can be more effective after rituximab treatment.
[0060] Pre-medication consisting of an antipyretic and antihistamine medication can be administered before infusion of lilotomab.
[0061] Thus, an aspect of the present invention relates to .sup.177Lu-lilotomab satetraxetan and lilotomab for use the treatment of Non-Hodgkin lymphoma, wherein .sup.177Lu-lilotomab satetraxetan is administered according to a specific administration pattern.
Method of Treatment and for Use in Treatment
[0062] An aspect of the present invention relates to .sup.177Lu-lilotomab satetraxetan for use in the treatment of Non-Hodgkin lymphoma, wherein .sup.177Lu-lilotomab satetraxetan is administered according to an administration pattern comprising predosing of 20-250 mg/m.sup.2 lilotomab, followed by 10-50 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0063] The predosing of 20-250 mg/m.sup.2 lilotomab may be substituted with 40-500 mg/patient in all aspects and embodiments of the invention.
[0064] A further aspect of the present invention relates to lilotomab for use in the treatment of Non-Hodgkin lymphoma wherein lilotomab is administered according to an administration pattern comprising predosing of 20-250 mg/m.sup.2 lilotomab, followed by 10-50 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0065] A further aspect of the present invention relates to a combination of lilotomab and .sup.177Lu-lilotomab satetraxetan for use in the treatment of Non-Hodgkin lymphoma wherein lilotomab and .sup.177Lu-lilotomab satetraxetan is administered according to an administration pattern comprising predosing of 20-250 mg/m.sup.2 lilotomab, followed by 10-50 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0066] Yet another aspect of the present invention relates to lilotomab for use in the reduction of haematological toxicity due to the administration of .sup.177Lu-lilotomab satetraxetan, wherein lilotomab is administered before .sup.177Lu-lilotomab satetraxetan in a dose of 20-250 mg/m.sup.2.
[0067] Another aspect of the present invention relates to a method of treating Non-Hodgkin lymphoma comprising administration of .sup.177Lu-lilotomab satetraxetan in an administration pattern comprising predosing of 20-250 mg/m.sup.2 lilotomab, followed by 10-50 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0068] The therapy or treatment of the present invention can be administered either as a monotherapy or in combination with other therapies, preferentially standard treatments.
[0069] Such other therapies may be one or more selected from the group consisting of pretreatment, surgery, chemotherapy (including doxorubicin, vinblastin and gemcitabine), immunotherapy, antibody therapy, photodynamic therapy, proteasome inhibitor (including bortezomib), histone deacetylase inhibitors (including vorinostat and suberoylanilide hydroxamic acid), vitamin D3 and vitamin D3 analogs, cell cycle checkpoint inhibitors (including UJCN-01 and 2-(4-(4-Chlorophenoxy)phenyl)-1H-benzimidazole-5-carboxamide), hypoxic cell radiosensitizers (including metronidazole and misonidazole), apoptosis inducers (including withaferin A and venetoclax), radiosensitizers, radioimmunotherapy or a combination of two or more of these.
[0070] In one embodiment of the present invention has the patient being treated according to the present invention already been undergoing treatment for cancer.
[0071] In one embodiment of the present invention is this treatment of therapy one or more of those mentioned above. In a preferred embodiment is the therapy rituximab, and in this case can the patient be a patient relapsing after rituximab treatment.
[0072] Thus, an embodiment of the present invention relates to .sup.177Lu-lilotomab satetraxetan for use in the treatment of Non-Hodgkin lymphoma according to the present invention, wherein the patient is relapsing after treatment with rituximab.
Lilotomab and .SUP.177.Lu-Lilotomab Satetraxetan
[0073] The monoclonal antibody (mAb or moAb) lilotomab was previously known as tetulomab or HH1 while .sup.177Lu-lilotomab satetraxetan was previously known as .sup.177Lu-labeled HH1 antibody, or named .sup.177Lu-tetulomab or by the tradename Betalutin.
[0074] .sup.177Lu-lilotomab satetraxetan is a radioimmunoconjugate (RIC) also known as antibody radionuclide conjugate (ARC) that is capable of binding to or targeting an antigen of interest. In the present case is this antigen CD37.
[0075] Satetraxetan is a derivative of DOTA, p-SCN-benzyl-DOTA.
Administration Route
[0076] By administered is meant intravenous infusion or intravenous injection. More specifically, the radioimmunoconjugate and antibody of the present invention can be administered directly in a vein by a peripheral cannula connected to a drip chamber that prevents air embolism and allows an estimate of flow rate into the patient.
[0077] In one embodiment the radioimmunoconjugate and/or antibody can be administered in a repeated fashion.
[0078] In another embodiment the radioimmunoconjugate followed by monoclonal antibody (or immunoconjugate) can both be administered in a repeated fashion.
[0079] An embodiment of the present invention relates to the use of the radioimmunoconjugate and/or antibody of the present invention administered in combination with or in addition to other therapy.
[0080] In an embodiment of the present invention the other therapies are selected from pretreatment, chemotherapy, monoclonal antibody therapy, surgery, radiotherapy, and/or photodynamic therapy.
[0081] In another embodiment of the present invention the other therapies are bone marrow transplantation or stem cell transplantation and/or therapy
Administration Dosages
[0082] In the present invention is .sup.177Lu-lilotomab satetraxetan used in the treatment of Non-Hodgkin's lymphoma. An embodiment of the present invention relates to .sup.177Lu-lilotomab satetraxetan administered at a concentration selected from the group consisting of 10, 12.5, 15, 17.5, 20, 25, 30, 35, 40, 45, 50 MBq/kg.
[0083] An embodiment of the present invention relates to .sup.177Lu-lilotomab satetraxetan administered at a concentration of 10 MBq/kg.
[0084] Another embodiment of the present invention relates to .sup.177Lu-lilotomab satetraxetan administered at a concentration of 12.5 MBq/kg.
[0085] A further embodiment of the present invention relates to .sup.177Lu-lilotomab satetraxetan administered at a concentration of 15 MBq/kg.
[0086] Yet another embodiment of the present invention relates to .sup.177Lu-lilotomab satetraxetan administered at a concentration of 17.5 MBq/kg.
[0087] Another embodiment of the present invention relates to .sup.177Lu-lilotomab satetraxetan administered at a concentration of 20 MBq/kg.
[0088] Another embodiment of the present invention relates to .sup.177Lu-lilotomab satetraxetan administered at a concentration of 25 MBq/kg.
[0089] Yet another embodiment of the present invention relates to .sup.177Lu-lilotomab satetraxetan administered at a concentration of 17.5-20 MBq/kg.
[0090] Yet another embodiment of the present invention relates to .sup.177Lu-lilotomab satetraxetan administered at a concentration of 20-25 MBq/kg.
[0091] Yet another embodiment of the present invention relates to .sup.177Lu-lilotomab satetraxetan administered at a concentration of 25-30 MBq/kg.
[0092] Yet another embodiment of the present invention relates to .sup.177Lu-lilotomab satetraxetan administered at a concentration of 30-35 MBq/kg.
[0093] Yet another embodiment of the present invention relates to .sup.177Lu-lilotomab satetraxetan administered at a concentration of 35-40 MBq/kg.
[0094] Yet another embodiment of the present invention relates to .sup.177Lu-lilotomab satetraxetan administered at a concentration of 40-45 MBq/kg.
[0095] Yet another embodiment of the present invention relates to .sup.177Lu-lilotomab satetraxetan administered at a concentration of 45-50 MBq/kg.
[0096] Lilotomab is used for predosing before administration of .sup.177Lu-lilotomab satetraxetan.
[0097] An embodiment of the present invention relates to lilotomab administered at a concentration of 40 mg/patient.
[0098] Another embodiment of the present invention relates to lilotomab administered at a concentration of 2-50 mg/patient.
[0099] Another embodiment of the present invention relates to lilotomab administered at a concentration of 40 mg/patient.
[0100] Another embodiment of the present invention relates to lilotomab administered at a concentration of 100 mg/patient.
[0101] Another embodiment of the present invention relates to lilotomab administered at a concentration of 120 mg/patient.
[0102] Another embodiment of the present invention relates to lilotomab administered at a concentration of 150 mg/patient.
[0103] Another embodiment of the present invention relates to lilotomab administered at a concentration of 200 mg/patient.
[0104] Another embodiment of the present invention relates to lilotomab administered at a concentration of 20 mg/m.sup.2.
[0105] Another embodiment of the present invention relates to lilotomab administered at a concentration of 40 mg/m.sup.2.
[0106] Another embodiment of the present invention relates to lilotomab administered at a concentration of 60 mg/m.sup.2.
[0107] Another embodiment of the present invention relates to predosing of lilotomab administered at a concentration of 20 mg/m.sup.2 followed by .sup.177Lu-lilotomab satetraxetan administered at a concentration of 15 MBq/kg.
[0108] Another embodiment of the present invention relates to predosing of lilotomab administered at a concentration of 20 mg/m.sup.2 followed by .sup.177Lu-lilotomab satetraxetan administered at a concentration of 17.5 MBq/kg.
[0109] Another embodiment of the present invention relates to predosing of lilotomab administered at a concentration of 20 mg/m.sup.2 followed by 177Lu-lilotomab satetraxetan administered at a concentration of 20 MBq/kg.
[0110] Another embodiment of the present invention relates to predosing of lilotomab administered at a concentration of 40 mg/m.sup.2 followed by .sup.177Lu-lilotomab satetraxetan administered at a concentration of 15 MBq/kg.
[0111] Another embodiment of the present invention relates to predosing of lilotomab administered at a concentration of 40 mg/m.sup.2 followed by .sup.177Lu-lilotomab satetraxetan administered at a concentration of 17.5 MBq/kg.
[0112] Another embodiment of the present invention relates to predosing of lilotomab administered at a concentration of 100 mg/m.sup.2 followed by .sup.177Lu-lilotomab satetraxetan administered at a concentration of 15 MBq/kg.
[0113] Another embodiment of the present invention relates to predosing of lilotomab administered at a concentration of 100 mg/m followed by .sup.177Lu-lilotomab satetraxetan administered at a concentration of 17.5 MBq/kg.
[0114] Another embodiment of the present invention relates to predosing of lilotomab administered at a concentration of 40 mg/m.sup.2 followed by .sup.177Lu-lilotomab satetraxetan administered at a concentration of 20 MBq/kg.
[0115] Another embodiment of the present invention relates to predosing of lilotomab administered at a concentration of 100 mg/m.sup.2 followed by .sup.177Lu-lilotomab satetraxetan administered at a concentration of 20 MBq/kg.
[0116] Another embodiment of the present invention relates to predosing of lilotomab administered at a concentration of 40 mg/patient followed by .sup.177Lu-lilotomab satetraxetan administered at a concentration of 15 MBq/kg.
[0117] Another embodiment of the present invention relates to predosing of lilotomab administered at a concentration of 40 mg/patient followed by .sup.177Lu-lilotomab satetraxetan administered at a concentration of 17.5 MBq/kg.
[0118] Another embodiment of the present invention relates to predosing of lilotomab administered at a concentration of 40 mg/patient followed by .sup.177Lu-lilotomab satetraxetan administered at a concentration of 17.5 MBq/kg.
[0119] Another embodiment of the present invention relates to predosing of lilotomab administered at a concentration of 100 mg/patient followed by .sup.177Lu-lilotomab satetraxetan administered at a concentration of 15 MBq/kg.
[0120] Another embodiment of the present invention relates to predosing of lilotomab administered at a concentration of 40 mg/patient followed by .sup.177Lu-lilotomab satetraxetan administered at a concentration of 20 MBq/kg.
[0121] Another embodiment of the present invention relates to predosing of lilotomab administered at a concentration of 100 mg/patient followed by .sup.177Lu-lilotomab satetraxetan administered at a concentration of 20 MBq/kg.
[0122] Another embodiment of the present invention relates to predosing of lilotomab administered at a concentration of 50 mg/patient followed by .sup.177Lu-lilotomab satetraxetan administered at a concentration of 20 MBq/kg.
[0123] Another embodiment of the present invention relates to predosing of lilotomab administered at a concentration of 60 mg/patient followed by .sup.177Lu-lilotomab satetraxetan administered at a concentration of 20 MBq/kg.
[0124] A further embodiment of the present invention relates to lilotomab administered at a concentration of 50 mg/m.sup.2. This may in an embodiment of the invention be equal to 100 mg/patient.
[0125] A further embodiment of the present invention relates to lilotomab administered at a concentration of 60 mg/m.sup.2. This may in an embodiment of the invention be equal to 120 mg/patient.
[0126] Another embodiment of the present invention relates to lilotomab administered at a concentration of 75 mg/m.sup.2. This may in an embodiment of the invention be equal to 150 mg/patient.
[0127] Yet another embodiment of the present invention relates to lilotomab administered at a concentration of 100 mg/m.sup.2. This may in an embodiment of the invention be equal to 200 mg/patient.
[0128] Another embodiment of the present invention relates to lilotomab administered at a concentration of 125 mg/m.sup.2. This may in an embodiment of the invention be equal to 250 mg/patient.
[0129] A further embodiment of the present invention relates to lilotomab administered at a concentration of 150 mg/m.sup.2. This may in an embodiment of the invention be equal to 300 mg/patient. Another embodiment of the present invention relates to lilotomab administered at a concentration of 175 mg/m.sup.2. This may in an embodiment of the invention be equal to 350 mg/patient.
[0130] A further embodiment of the present invention relates to lilotomab administered at a concentration of 200 mg/m.sup.2. This may in an embodiment of the invention be equal to 400 mg/patient. Another embodiment of the present invention relates to lilotomab administered at a concentration of 225 mg/m.sup.2. This may in an embodiment of the invention be equal to 450 mg/patient.
[0131] Another embodiment of the present invention relates to lilotomab administered at a concentration of 40 mg/patient.
[0132] Another embodiment of the present invention relates to lilotomab administered at a concentration of 50 mg/patient.
[0133] Another embodiment of the present invention relates to lilotomab administered at a concentration of 60 mg/patient.
[0134] Yet another embodiment of the present invention relates to lilotomab administered at a concentration of 250 mg/m.sup.2. This may in an embodiment of the invention be equal to 500 mg/patient. Another embodiment of the present invention relates to lilotomab administered at a concentration of 20-250 mg/m.sup.2. This may in an embodiment of the invention be equal to 10-125 mg/patient A further embodiment of the present invention relates to lilotomab administered at a concentration of 20-100 mg/m.sup.2. This may in an embodiment of the invention be equal to 40-200 mg/patient.
[0135] Another embodiment of the present invention relates to lilotomab administered at a concentration of 20-150 mg/m.sup.2. This may in an embodiment of the invention be equal to 40-300 mg/patient.
[0136] A further embodiment of the present invention relates to lilotomab administered at a concentration of 100-200 mg/m.sup.2. This may in an embodiment of the invention be equal to 200-400 mg/patient.
[0137] Another embodiment of the present invention relates to .sup.177Lu-lilotomab satetraxetan administered at a concentration of 15-20 MBq/kg and lilotomab administered at a concentration of 20-100 mg/m.sup.2.
[0138] Yet another embodiment of the present invention relates to .sup.177Lu-lilotomab satetraxetan administered at a concentration of 15-20 MBq/kg and lilotomab administered at a concentration of 40-100 mg/m.sup.2. This may in an embodiment of the invention be equal to 80-200 mg/patient.
[0139] Another embodiment of the present invention relates to .sup.177W-lilotomab satetraxetan administered at a concentration of 17.5-20 MBq/kg and lilotomab administered at a concentration of 40-100 mg/m.sup.2.
[0140] A further embodiment of the present invention relates to .sup.177W-lilotomab satetraxetan administered at a concentration of 15 MBq/kg and lilotomab administered at a concentration of 100 mg/m.sup.2.
[0141] Another embodiment of the present invention relates to .sup.177Lu-lilotomab satetraxetan administered at a concentration of 17.5 MBq/kg and lilotomab administered at a concentration of 100 mg/m.sup.2.
[0142] Yet another embodiment of the present invention relates to .sup.177Lu-lilotomab satetraxetan administered at a concentration of 20 MBq/kg and lilotomab administered at a concentration of 100 mg/m.sup.2.
[0143] Yet another embodiment of the present invention relates to .sup.177Lu-lilotomab satetraxetan administered at a concentration of 25 MBq/kg and lilotomab administered at a concentration of 100 mg/m.sup.2.
[0144] Yet another embodiment of the present invention relates to .sup.177Lu-lilotomab satetraxetan administered at a concentration of 30 MBq/kg and lilotomab administered at a concentration of 100 mg/m.sup.2.
[0145] Yet another embodiment of the present invention relates to .sup.177Lu-lilotomab satetraxetan administered at a concentration of 35 MBq/kg and lilotomab administered at a concentration of 100 mg/m.sup.2.
[0146] Yet another embodiment of the present invention relates to .sup.177Lu-lilotomab satetraxetan administered at a concentration of 40 MBq/kg and lilotomab administered at a concentration of 100 mg/m.sup.2.
[0147] Yet another embodiment of the present invention relates to .sup.177Lu-lilotomab satetraxetan administered at a concentration of 45 MBq/kg and lilotomab administered at a concentration of 100 mg/m.sup.2.
[0148] Yet another embodiment of the present invention relates to .sup.177Lu-lilotomab satetraxetan administered at a concentration of 50 MBq/kg and lilotomab administered at a concentration of 100 mg/m.sup.2.
[0149] Yet another embodiment of the present invention relates to .sup.177Lu-lilotomab satetraxetan administered at a concentration of 15 MBq/kg and lilotomab administered at a concentration of 60 mg/m.sup.2.
[0150] Yet another embodiment of the present invention relates to .sup.177Lu-lilotomab satetraxetan administered at a concentration of 20 MBq/kg and lilotomab administered at a concentration of 60 mg/m.sup.2.
[0151] Yet another embodiment of the present invention relates to .sup.177Lu-lilotomab satetraxetan administered at a concentration of 25 MBq/kg and lilotomab administered at a concentration of 60 mg/m.sup.2.
[0152] Yet another embodiment of the present invention relates to .sup.177Lu-lilotomab satetraxetan administered at a concentration of 30 MBq/kg and lilotomab administered at a concentration of 60 mg/m.sup.2.
[0153] A further embodiment of the present invention relates to .sup.177Lu-lilotomab satetraxetan administered at a concentration of 15 MBq/kg and lilotomab administered at a concentration of 40-100 mg/m.sup.2.
[0154] Another embodiment of the present invention relates to .sup.177Lu-lilotomab satetraxetan administered at a concentration of 17.5 MBq/kg and lilotomab administered at a concentration of 40-100 mg/m.sup.2.
[0155] Yet another embodiment of the present invention relates to .sup.177Lu-lilotomab satetraxetan administered at a concentration of 20 MBq/kg and lilotomab administered at a concentration of 40-100 mg/m.sup.2.
[0156] A further embodiment of the present invention relates to .sup.177Lu-lilotomab satetraxetan administered at a concentration of 25 MBq/kg and lilotomab administered at a concentration of 40-100 mg/m.sup.2.
[0157] Another embodiment of the present invention relates to .sup.177Lu-lilotomab satetraxetan administered at a concentration of 30 MBq/kg and lilotomab administered at a concentration of 40-100 mg/m.sup.2.
[0158] Yet another embodiment of the present invention relates to .sup.177Lu-lilotomab satetraxetan administered at a concentration of 35 MBq/kg and lilotomab administered at a concentration of 40-100 mg/m.sup.2.
[0159] A further embodiment of the present invention relates to .sup.177Lu-lilotomab satetraxetan administered at a concentration of 40 MBq/kg and lilotomab administered at a concentration of 40-100 mg/m.sup.2.
[0160] Another embodiment of the present invention relates to .sup.177Lu-lilotomab satetraxetan administered at a concentration of 45 MBq/kg and lilotomab administered at a concentration of 40-100 mg/m.sup.2.
[0161] Yet another embodiment of the present invention relates to .sup.177Lu-lilotomab satetraxetan administered at a concentration of 50 MBq/kg and lilotomab administered at a concentration of 40-100 mg/m.sup.2.
[0162] The PK profiles (e.g.
[0163] Thus, in one embodiment of the present invention is the activity (in kBq/ml) after 72 hours more than 80 kBq/ml, such as more than 70 kBq/ml, such as more than 60 kBq/ml.
[0164] In another embodiment of the present invention is the activity (in kBq/ml) after 48 hours more than 110 kBq/ml, such as more than 100 kBq/ml, such as more than 90 kBq/ml, such as more than 80 kBq/ml.
Haematological Toxicity
[0165] The administration of immunosuppressive agents may be associated with the occurrence of hematologic toxicity, such as anemia, due to bone marrow suppression or hemolysis, leukopenia, neutropenia and thrombocytopenia.
[0166] Neutropenia is graded; grade 1 is Neutrophils <LLN to 1500/mm.sup.3, grade 2 is Neutrophils <1500/mm.sup.3 to 1000/mm.sup.3, grade 3 is Neutrophils <1000/mm.sup.3 to 500/mm.sup.3, and grade 4 is Neutrophils <500/mm.sup.3 (see also
[0167] Thrombocytopenia is graded; grade 1 is Platelets <LLN to 75,000/mm.sup.3, grade 2 is <75,000/mm.sup.3 to 50,000/mm.sup.3, grade 3 is <50,000/mm.sup.3 to 25,000/mm.sup.3, and grade 4 is <25,000/mm.sup.3 (see also
[0168] Preferably is no neutropenia grade 4 observed after the treatment, and even more preferably is no grade 3 or 4 observed 45 days after the treatment.
[0169] Preferably is no thrombocytopenia grade 4 observed after the treatment, and even more preferably is no grade 3 or 4 observed 45 days after the treatment.
[0170] In one embodiment is no grade 3 or 4 neutropenia and thrombocytopenia or no grade 3 neutropenia and thrombocytopenia observed 45 days after the treatment.
[0171] Neutropenia and thrombocytopenia in patients can for example be seen in example 1 and
[0172] An aspect of the present invention relates to the use of lilotomab to reduce hematologic toxicity such as neutropenia and/or thrombocytopenia in patients suffering from non-Hodgkin's lymphoma. These patients may previously be treated with rituximab. The patients may also subsequently be treated with .sup.177Lu-lilotomab satetraxetan as disclosed herein.
Admiration Timing
[0173] As noted above the radioimmunoconjugates and/or antibody can be used in combination with other types of therapy.
[0174] Thus, in a further embodiment of the present invention is the use for a combinational therapy where the radioimmunoconjugate followed by simultaneous or post-treatment with antibody therapy, immunoconjugate therapy or a combination thereof, as described elsewhere herein.
[0175] Such therapy or treatment may be a monoclonal antibody selected from rituximab and lilotomab (HH1) depending on the antigen in focus.
[0176] The therapy can be repeated in cyclic pattern where administration of the radioimmunoconjugates and the monoclonal antibodies are repeated once, twice or several times.
[0177] A further embodiment of the present invention relates to the predosing of lilotomab done less than 24 hours, such as within 4 hours before administration of .sup.177Lu-lilotomab satetraxetan.
[0178] Another embodiment of the present invention relates to the predosing of lilotomab done less than 12 hours before administration of .sup.177Lu-lilotomab satetraxetan.
[0179] A further embodiment of the present invention relates to the predosing of lilotomab done less than 8 hours before administration of .sup.177Lu-lilotomab satetraxetan.
[0180] Yet another embodiment of the present invention relates to the predosing of lilotomab done less than 4 hours before administration of .sup.177Lu-lilotomab satetraxetan.
[0181] A further embodiment of the present invention relates to the predosing of lilotomab done less than 2 hours before administration of .sup.177Lu-lilotomab satetraxetan.
Rituximab Administration
[0182] Rituximab is a monoclonal antibody against the protein CD20, which is primarily found on the surface of immune system B cells.
[0183] Another embodiment of the present invention relates to the uses and methods of the present invention further comprising a pretreatment step before predosing wherein the pretreatment step comprises pretreatment with one, two, three or more injections or infusions of 375 mg/m.sup.2 rituximab.
[0184] Another embodiment of the present invention relates to the uses and methods of the present invention further comprising a pretreatment step before predosing wherein the pretreatment step comprises pretreatment with one injection or infusion of 375 mg/m.sup.2 rituximab.
[0185] Another embodiment of the present invention relates to the uses and methods of the present invention further comprising a pretreatment step before predosing wherein the pretreatment step comprises pretreatment with two injections or infusions of 375 mg/m.sup.2 rituximab.
[0186] Another embodiment of the present invention relates to the uses and methods of the present invention further comprising a pretreatment step before predosing wherein the pretreatment step comprises pretreatment with three or more injections or infusions of 375 mg/m.sup.2 rituximab.
[0187] Another embodiment of the present invention relates to the uses and methods of the present invention further comprising a pretreatment step before predosing wherein the pretreatment step comprises pretreatment with one, two, three or more injections or infusions of 100-750 mg/m.sup.2 rituximab.
[0188] Another embodiment of the present invention relates to the uses and methods of the present invention further comprising a pretreatment step before predosing wherein the pretreatment step comprises pretreatment with one, two, three or more injections or infusions of 200-750 mg/m.sup.2 rituximab.
[0189] Another embodiment of the present invention relates to the uses and methods of the present invention further comprising a pretreatment step before predosing wherein the pretreatment step comprises pretreatment with one, two, three or more injections or infusions of 300-700 mg/m.sup.2 rituximab.
[0190] Another embodiment of the present invention relates to the uses and methods of the present invention further comprising a pretreatment step before predosing wherein the pretreatment step comprises pretreatment with 375 mg/m.sup.2 rituximab. This treatment can be repeated, once, twice or several times.
[0191] Rituximab can be injected or infused. The pretreatment can be done 28-7 days before administration of .sup.177Lu-lilotomab satetraxetan.
[0192] Another embodiment of the present invention relates to rituximab infused or injected once or twice 28-14 days before administration of .sup.177Lu-lilotomab satetraxetan. An additional infusion or injection of rituximab can be done less than 4 hours before administration of .sup.177Lu-lilotomab satetraxetan.
[0193] Another embodiment of the present invention relates to rituximab infused or injected once or twice 10-18 days before administration of .sup.177Lu-lilotomab satetraxetan.
[0194] Another embodiment of the present invention relates to rituximab infused or injected once, twice, or three times at day 28, 21 or 14 before administration of .sup.177Lu-lilotomab satetraxetan.
[0195] Yet another embodiment of the present invention relates to 375 mg/m.sup.2 rituximab infused or injected at 28 and 21 days before administration of .sup.177Lu-lilotomab satetraxetan.
[0196] A further embodiment of the present invention relates to 375 mg/m.sup.2 rituximab infused or injected at 14 days before administration of .sup.177Lu-lilotomab satetraxetan.
[0197] Another embodiment of the present invention relates to 375 mg/m.sup.2 rituximab infused or injected at 14 days and again less than 4 hours before administration of .sup.177Lu-lilotomab satetraxetan
Specific Administration Patterns
[0198] An aspect of the present invention relates to .sup.177Lu-lilotomab satetraxetan for use in the treatment of Non-Hodgkin lymphoma, wherein .sup.177Lu-lilotomab satetraxetan is administered according in an administration pattern comprising predosing of 40 mg/patient of lilotomab, followed by 15 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0199] An aspect of the present invention relates to .sup.177Lu-lilotomab satetraxetan for use in the treatment of Non-Hodgkin lymphoma, wherein .sup.177Lu-lilotomab satetraxetan is administered according in an administration pattern comprising predosing of 100 mg/m.sup.2 lilotomab, followed by 15 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof. Another aspect of the present invention relates to .sup.177Lu-lilotomab satetraxetan for use in the treatment of Non-Hodgkin lymphoma, wherein .sup.177Lu-lilotomab satetraxetan is administered according in an administration pattern comprising predosing of 40 mg/m.sup.2 lilotomab, followed by 17.5 MBq/kg .sup.177W-lilotomab satetraxetan to a person in need thereof.
[0200] A further aspect of the present invention relates to .sup.177Lu-lilotomab satetraxetan for use in the treatment of Non-Hodgkin lymphoma, wherein .sup.177W-lilotomab satetraxetan is administered according in an administration pattern comprising predosing of 60 mg/m.sup.2 lilotomab, followed by 20 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0201] A further aspect of the present invention relates to .sup.177Lu-lilotomab satetraxetan for use in the treatment of Non-Hodgkin lymphoma, wherein .sup.177Lu-lilotomab satetraxetan is administered according to an administration pattern comprising predosing of 100 mg/m.sup.2 lilotomab, followed by 25 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0202] A further aspect of the present invention relates to .sup.177Lu-lilotomab satetraxetan for use in the treatment of Non-Hodgkin lymphoma, wherein .sup.177Lu-lilotomab satetraxetan is administered according in an administration pattern comprising predosing of 100 mg/m.sup.2 lilotomab, followed by 30 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0203] A further aspect of the present invention relates to .sup.177Lu-lilotomab satetraxetan for use in the treatment of Non-Hodgkin lymphoma, wherein .sup.177Lu-lilotomab satetraxetan is administered according in an administration pattern comprising predosing of 100 mg/m.sup.2 lilotomab, followed by 35 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0204] A further aspect of the present invention relates to .sup.177Lu-lilotomab satetraxetan for use in the treatment of Non-Hodgkin lymphoma, wherein .sup.177Lu-lilotomab satetraxetan is administered according in an administration pattern comprising predosing of 100 mg/m.sup.2 lilotomab, followed by 45 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0205] A further aspect of the present invention relates to .sup.177Lu-lilotomab satetraxetan for use in the treatment of Non-Hodgkin lymphoma, wherein .sup.177Lu-lilotomab satetraxetan is administered according in an administration pattern comprising predosing of 100 mg/m.sup.2 lilotomab, followed by 50 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0206] An aspect of the present invention relates to .sup.177Lu-lilotomab satetraxetan for use the treatment of Non-Hodgkin lymphoma, wherein .sup.177Lu-lilotomab satetraxetan is administered according in an administration pattern comprising predosing of 100 mg/m.sup.2 lilotomab, followed by 15 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0207] Another aspect of the present invention relates to .sup.177Lu-lilotomab satetraxetan for use the treatment of Non-Hodgkin lymphoma, wherein .sup.177Lu-lilotomab satetraxetan is administered according in an administration pattern comprising predosing of 100 mg/m.sup.2 lilotomab, followed by 17.5 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0208] An aspect of the present invention relates to .sup.177Lu-lilotomab satetraxetan for use the treatment of Non-Hodgkin lymphoma, wherein .sup.177Lu-lilotomab satetraxetan is administered according in an administration pattern comprising predosing of 100 mg/m.sup.2 lilotomab, followed by 20 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0209] An aspect of the present invention relates to .sup.177Lu-lilotomab satetraxetan for use the treatment of Non-Hodgkin lymphoma, wherein .sup.177Lu-lilotomab satetraxetan is administered according in an administration pattern comprising predosing of 100 mg/m.sup.2 lilotomab, followed by 25 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0210] An aspect of the present invention relates to .sup.177Lu-lilotomab satetraxetan for use the treatment of Non-Hodgkin lymphoma, wherein .sup.177Lu-lilotomab satetraxetan is administered according in an administration pattern comprising predosing of 100 mg/m.sup.2 lilotomab, followed by 30 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0211] An aspect of the present invention relates to .sup.177Lu-lilotomab satetraxetan for use in the treatment of Non-Hodgkin lymphoma, wherein .sup.177Lu-lilotomab satetraxetan is administered according in an administration pattern comprising pretreatment using 375 mg/m.sup.2 rituximab 14 days prior to administration of .sup.177Lu-lilotomab satetraxetan, predosing of 100 mg/lilotomab, followed by 15 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0212] An aspect of the present invention relates to .sup.177Lu-lilotomab satetraxetan for use the treatment of Non-Hodgkin lymphoma, wherein .sup.177Lu-lilotomab satetraxetan is administered according in an administration pattern comprising pretreatment using 375 mg/m.sup.2 rituximab 14 days prior to administration of .sup.177Lu-lilotomab satetraxetan, predosing of 100 mg/m.sup.2 lilotomab, followed by 17.5 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0213] An aspect of the present invention relates to .sup.177Lu-lilotomab satetraxetan for use the treatment of Non-Hodgkin lymphoma, wherein .sup.177Lu-lilotomab satetraxetan is administered according in an administration pattern comprising pretreatment using 375 mg/m.sup.2 rituximab 14 days prior to administration of .sup.177Lu-lilotomab satetraxetan, predosing of 100 mg/m.sup.2 lilotomab, followed by 20 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0214] An aspect of the present invention relates to .sup.177Lu-lilotomab satetraxetan for use the treatment of Non-Hodgkin lymphoma, wherein .sup.177Lu-lilotomab satetraxetan is administered according in an administration pattern comprising pretreatment using 375 mg/m.sup.2 rituximab 14 days prior to administration of .sup.177Lu-lilotomab satetraxetan, predosing of 100 mg/m.sup.2 lilotomab, followed by 25 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0215] An aspect of the present invention relates to .sup.177Lu-lilotomab satetraxetan for use the treatment of Non-Hodgkin lymphoma, wherein .sup.177Lu-lilotomab satetraxetan is administered according in an administration pattern comprising pretreatment using 375 mg/m.sup.2 rituximab 14 days prior to administration of .sup.177Lu-lilotomab satetraxetan, predosing of 100 mg/m.sup.2 lilotomab, followed by 30 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0216] Another aspect of the present invention relates to .sup.177Lu-lilotomab satetraxetan for use the treatment of Non-Hodgkin lymphoma, wherein .sup.177Lu-lilotomab satetraxetan is administered according in an administration pattern comprising pretreatment using 375 mg/m.sup.2 rituximab 14 days before administration of .sup.177Lu-lilotomab satetraxetan and again less than 4 hours before administration of .sup.177Lu-lilotomab satetraxetan, predosing of 100 mg/m.sup.2 lilotomab less than 4 hours before administration of .sup.177Lu-lilotomab satetraxetan, followed by 15 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0217] Another aspect of the present invention relates to .sup.177Lu-lilotomab satetraxetan for use the treatment of Non-Hodgkin lymphoma, wherein .sup.177Lu-lilotomab satetraxetan is administered according in an administration pattern comprising pretreatment using 375 mg/m.sup.2 rituximab 14 days before administration of .sup.177Lu-lilotomab satetraxetan and again less than 4 hours before administration of .sup.177Lu-lilotomab satetraxetan, predosing of 100 mg/m.sup.2 lilotomab less than 4 hours before administration of .sup.177Lu-lilotomab satetraxetan, followed by 17.5 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0218] A further aspect of the present invention relates to .sup.177Lu-lilotomab satetraxetan for use the treatment of Non-Hodgkin lymphoma, wherein .sup.177Lu-lilotomab satetraxetan is administered according in an administration pattern comprising pretreatment using 375 mg/m.sup.2 rituximab 14 days before administration of .sup.177Lu-lilotomab satetraxetan and again less than 4 hours before administration of .sup.177Lu-lilotomab satetraxetan, predosing of 100 ng/m.sup.2 lilotomab less than 4 hours before administration of 177Lu-lilotomab satetraxetan, followed by 20 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0219] A further aspect of the present invention relates to .sup.177Lu-lilotomab satetraxetan for use the treatment of Non-Hodgkin lymphoma, wherein .sup.177Lu-lilotomab satetraxetan is administered according in an administration pattern comprising pretreatment using 375 mg/m.sup.2 rituximab 14 days before administration of .sup.177Lu-lilotomab satetraxetan and again less than 4 hours before administration of .sup.177Lu-lilotomab satetraxetan, predosing of 100 mg/m.sup.2 lilotomab less than 4 hours before administration of .sup.177Lu-lilotomab satetraxetan, followed by 25 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0220] A further aspect of the present invention relates to .sup.177Lu-lilotomab satetraxetan for use the treatment of Non-Hodgkin lymphoma, wherein .sup.177Lu-lilotomab satetraxetan is administered according in an administration pattern comprising pretreatment using 375 mg/m.sup.2 rituximab 14 days before administration of .sup.177Lu-lilotomab satetraxetan and again less than 4 hours before administration of .sup.177Lu-lilotomab satetraxetan, predosing of 100 mg/m.sup.2 lilotomab less than 4 hours before administration of .sup.177Lu-lilotomab satetraxetan, followed by 30 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0221] Another aspect of the present invention relates to lilotomab for use in the treatment of Non-Hodgkin lymphoma wherein lilotomab is administered according to an administration pattern comprising pretreatment using 375 mg/m.sup.2 rituximab 14 days before administration of .sup.177Lu-lilotomab satetraxetan and again less than 4 hours before administration of .sup.177Lu-lilotomab satetraxetan, predosing of 100 mg/m.sup.2 lilotomab less than 4 hours before administration of .sup.177Lu-lilotomab satetraxetan, followed by 15 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0222] A further aspect of the present invention relates to a combination of lilotomab and .sup.177Lu-lilotomab satetraxetan for use in the treatment of Non-Hodgkin lymphoma wherein lilotomab and .sup.177Lu-lilotomab satetraxetan is administered according to an administration pattern comprising pretreatment using 375 mg/m.sup.2 rituximab 14 days before administration of .sup.177Lu-lilotomab satetraxetan and again less than 4 hours before administration of .sup.177Lu-lilotomab satetraxetan, predosing of 100 mg/m.sup.2 lilotomab less than 4 hours before administration of .sup.177Lu-lilotomab satetraxetan, followed by 15 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0223] A further aspect of the present invention relates to a combination of lilotomab and .sup.177Lu-lilotomab satetraxetan for use in the treatment of Non-Hodgkin lymphoma wherein lilotomab and .sup.177Lu-lilotomab satetraxetan is administered according to an administration pattern comprising pretreatment using 375 mg/m.sup.2 rituximab 14 days before administration of .sup.177Lu-lilotomab satetraxetan and again less than 4 hours before administration of .sup.177Lu-lilotomab satetraxetan, predosing of 100 mg/m.sup.2 lilotomab less than 4 hours before administration of .sup.177Lu-lilotomab satetraxetan, followed by 17.5 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0224] A further aspect of the present invention relates to a combination of lilotomab and .sup.177Lu-lilotomab satetraxetan for use in the treatment of Non-Hodgkin lymphoma wherein lilotomab and .sup.177Lu-lilotomab satetraxetan is administered according to an administration pattern comprising pretreatment using 375 mg/m.sup.2 rituximab 14 days before administration of .sup.177Lu-lilotomab satetraxetan and again less than 4 hours before administration of .sup.177Lu-lilotomab satetraxetan, predosing of 100 mg/m.sup.2 lilotomab less than 4 hours before administration of .sup.177Lu-lilotomab satetraxetan, followed by 20 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0225] A further aspect of the present invention relates to a combination of lilotomab and .sup.177Lu-lilotomab satetraxetan for use in the treatment of Non-Hodgkin lymphoma wherein lilotomab and .sup.177Lu-lilotomab satetraxetan is administered according to an administration pattern comprising pretreatment using 375 mg/m.sup.2 rituximab 14 days before administration of .sup.177Lu-lilotomab satetraxetan and again less than 4 hours before administration of .sup.177Lu-lilotomab satetraxetan, predosing of 100 mg/m.sup.2 lilotomab less than 4 hours before administration of .sup.177Lu-lilotomab satetraxetan, followed by 25 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0226] A further aspect of the present invention relates to a combination of lilotomab and .sup.177Lu-lilotomab satetraxetan for use in the treatment of Non-Hodgkin lymphoma wherein lilotomab and .sup.177Lu-lilotomab satetraxetan is administered according to an administration pattern comprising pretreatment using 375 mg/m.sup.2 rituximab 14 days before administration of .sup.177Lu-lilotomab satetraxetan and again less than 4 hours before administration of .sup.177Lu-lilotomab satetraxetan, predosing of 100 mg/m.sup.2 lilotomab less than 4 hours before administration of .sup.177Lu-lilotomab satetraxetan, followed by 30 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0227] Yet another aspect of the present invention relates to lilotomab for use in the reduction of haematological toxicity due to the administration of .sup.177Lu-lilotomab satetraxetan, wherein lilotomab is administered before .sup.177Lu-lilotomab satetraxetan in a dose of 100 mg/m.sup.2.
[0228] Another aspect of the present invention relates to a method of treating Non-Hodgkin lymphoma comprising administration of pretreatment using 375 mg/m.sup.2 rituximab 14 days before administration of .sup.177Lu-lilotomab satetraxetan and again less than 4 hours before administration of .sup.177Lu-lilotomab satetraxetan, predosing of 100 mg/m.sup.2 lilotomab less than 4 hours before administration of .sup.177Lu-lilotomab satetraxetan, followed by 15 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0229] Another aspect of the present invention relates to a method of treating Non-Hodgkin lymphoma comprising administration of pretreatment using 375 mg/m.sup.2 rituximab 14 days before administration of .sup.177Lu-lilotomab satetraxetan and again less than 4 hours before administration of .sup.177Lu-lilotomab satetraxetan, predosing of 100 mg/m.sup.2 lilotomab less than 4 hours before administration of .sup.177Lu-lilotomab satetraxetan, followed by 17.5 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0230] Another aspect of the present invention relates to a method of treating Non-Hodgkin lymphoma comprising administration of pretreatment using 375 mg/m.sup.2 rituximab 14 days before administration of .sup.177Lu-lilotomab satetraxetan and again less than 4 hours before administration of .sup.177Lu-lilotomab satetraxetan, predosing of 100 mg/m.sup.2 lilotomab less than 4 hours before administration of .sup.177Lu-lilotomab satetraxetan, followed by 20 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0231] Another aspect of the present invention relates to a method of treating Non-Hodgkin lymphoma comprising administration of pretreatment using 375 mg/m.sup.2 rituximab 14 days before administration of .sup.177Lu-lilotomab satetraxetan and again less than 4 hours before administration of .sup.177Lu-lilotomab satetraxetan, predosing of 100 mg/m.sup.2 lilotomab less than 4 hours before administration of .sup.177Lu-lilotomab satetraxetan, followed by 25 MBq/kg.sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0232] Another aspect of the present invention relates to a method of treating Non-Hodgkin lymphoma comprising administration of pretreatment using 375 mg/m.sup.2 rituximab 14 days before administration of .sup.177Lu-lilotomab satetraxetan and again less than 4 hours before administration of .sup.177Lu-lilotomab satetraxetan, predosing of 100 mg/m.sup.2 lilotomab less than 4 hours before administration of .sup.177Lu-lilotomab satetraxetan, followed by 30 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0233] The therapy or treatment of the present invention can be administered either as a monotherapy or in combination with other therapies, preferentially standard treatments.
[0234] An aspect of the present invention relates to the treatment patterns shown in Arm 1 of
[0235] An aspect of the present invention relates to the treatment patterns shown in Arm 2 of
[0236] An aspect of the present invention relates to the treatment patterns shown in Arm 3 of
[0237] An aspect of the present invention relates to the treatment patterns shown in Arm 4 of
[0238] Pre-medication consisting of an antipyretic and antihistamine medication can be administered before infusion of rituximab. The types of pre-medication are in accordance with each hospital's routine, including any use of corticosteroids.
Pharmaceutical Compositions
[0239] Antibodies and radioimmunoconjugates are usually applied in the treatment of diseases formulated in pharmaceutical compositions.
[0240] Such compositions are optimized for parameters such as physiological tolerance and shelf-life.
[0241] Thus, in one embodiment of the present invention is the radioimmunoconjugates and/or antibodies of the present invention formulated as a pharmaceutical composition.
[0242] An embodiment of the present invention relates to a pharmaceutical composition as described above, further comprising one or more additional therapeutic agents.
[0243] In another embodiment of the present invention are said one or more additional therapeutic agents selected from agents that induce apoptosis.
[0244] Usually is an important element of a pharmaceutical composition a buffer solution, which to a substantial degree maintain the chemical integrity of the radioimmunoconjugate and/or antibody and is being physiologically acceptable for infusion into patients.
[0245] In one embodiment of the present invention the pharmaceutical composition comprises one or more pharmaceutically acceptable carriers and/or adjuvants.
[0246] Acceptable pharmaceutical carriers include but are not limited to non-toxic buffers, fillers, isotonic solutions, etc. More specifically, the pharmaceutical carrier can be but are not limited to normal saline (0.9%), half-normal saline, Ringer's lactate, 5%) Dextrose, 3.3% Dextrose/0.3% Saline. The physiologically acceptable carrier can contain a radiolytic stabilizer, e.g., ascorbic acid, which protect the integrity of the radiopharmaceutical during storage and shipment.
[0247] In one embodiment of the present invention are lilotomab and Betalutin formulated as indicated in Tables 1 and 2 in Example 1.
[0248] Preferably are sodium dihydrogen phosphate monohydrate, sodium chloride, recombinant human albumin, sodium ascorbate, diethylenetriamine pentaacetic acid (DTPA) and sodium hydroxide used as excipients in the formulation buffer.
[0249] Preferably is phosphate included in the formulation buffer to maintain the pH of the finished product during the shelf life.
[0250] Preferably is recombinant human albumin included in the formulation buffer as a stabilizer for the lilotomab satetraxetan conjugate. The albumin also acts as a radioprotectant. Recombinant human albumin structurally identical to human serum albumin derived from yeast is used. No human- or animal-derived raw material is involved in its manufacture. The excipient is well known and is used in pharmaceutical products for human use.
[0251] Preferably is sodium ascorbate included in the formulation to act as a radiolytic scavenger to ensure the stability of Betalutin over the shelf-life of the product.
[0252] Preferably is DTPA introduced as an excipient in the Betalutin formulation to chelate any free .sup.177Lu.sup.3+ ions and to reroute this impurity from accumulation in the bone to rapid renal clearance (Li et al 2001, Breeman et al 2003). Betalutin contains 9.3 μmol DTPA in 12 mL, while the maximum amount of no-carrier added (n.c.a) .sup.177Lu.sup.3+ (>3,000 GBq/mg) applied (6.9 GBq) corresponds to less than 15 nmol Lu ions. This gives a more than 1000-fold molar excess of DTPA over Lu.sup.3+ ions. Furthermore, when taking into account that the majority of the Lu3+ ions 95%) is chelated to lilotomab satetraxetan, the molar excess is almost 100,000-fold. DTPA is therefore expected to chelate all free .sup.177Lu.sup.3+ ions quantitatively and .sup.177Lu-DTPA is thus specified as radiochemical impurity in the specification.
[0253] Preferably is the formulation buffer an aqueous solution with pH 6.9 to 7.0 and thus no incompatibilities between the drug substance and the formulation buffer are expected.
[0254] One embodiment of the present invention comprises the pharmaceutical composition of the present invention and one or more additional antibodies or radioimmunoconjugates.
[0255] As aspect of the present invention relates to a pharmaceutical composition comprising (per mL): 0.75 mg Lutetium (.sup.177Lu) lilotomab satetraxetan, 0.46 mg Ammonium acetate, and Trace amounts of HCl.sub.3.
[0256] Another aspect of the present invention relates to a pharmaceutical composition comprising (per mL): 30.86 mg Sodium ascorbate, 0.31 mg DTPA, 0.17 mg NaOH, 60.82 mg Recombinant human albumin, 3.32 mg Sodium dihydrogen phosphate monohydrate, and 4.34 mg Sodium chloride with the pH is adjusted to 6.9-7.0.
[0257] A further aspect of the present invention relates to a pharmaceutical composition comprising; 14% of the pharmaceutical composition comprising (per mL): 0.75 mg Lutetium (.sup.177Lu) lilotomab satetraxetan, 0.46 mg Ammonium acetate, and Trace amounts of HCl.sup.3, and 86% of the pharmaceutical composition comprising (per mL): 30.86 mg Sodium ascorbate, 0.31 mg DTPA, 0.17 mg NaOH, 60.82 mg Recombinant human albumin, 3.32 mg Sodium dihydrogen phosphate monohydrate, and 4.34 mg Sodium chloride with the pH is adjusted to 6.9-7.0.
[0258] The present invention also relates to the pharmaceutical compositions of the present examples, as well as the dosage administration patterns presented herein. This includes the use of the pharmaceutical compositions of the present invention for use in the treatment of Non-Hodgkin lymphoma.
Cancer Types
[0259] The person in need of treatment with .sup.177Lu-lilotomab satetraxetan is suffering from a CD37 related disease, typically a B-cell lymphoma such as Non-Hodgkin lymphoma (NHL).
[0260] NHL is a group of blood cancers that includes all types of lymphoma except Hodgkin's lymphomas. Symptoms include enlarged lymph nodes, fever, night sweats, weight loss, and feeling tired. Other symptoms may include bone pain, chest pain, or itchiness. Some forms are slow growing while others are fast growing.
[0261] There are several types of NHL. Thus, another embodiment of the present invention relates to the lymphoma being a subtype selected from the group consisting of follicular grade I-IIIA, marginal zone, small lymphocytic, lymphoplasmacytic, Diffuse large B-cell lymphoma, and mantle cell.
[0262] In an embodiment of the present invention is the NHL cancer follicular grade I-IIIA.
[0263] In an embodiment of the present invention is the NHL cancer marginal zone.
[0264] In an embodiment of the present invention is the NHL cancer small lymphocytic.
[0265] In an embodiment of the present invention is the NI-L cancer lymphoplasmacytic.
[0266] In an embodiment of the present invention is the NHL cancer mantle cell.
[0267] In an embodiment of the present invention is the NHL cancer AML.
[0268] In an embodiment of the present invention is the NHL cancer CLL
[0269] In an embodiment of the present invention is the NHL cancer Diffuse Large B-cell lymphoma (DLBCL).
[0270] Some cell types of leukemia also express the CD37 antigen. Thus, another embodiment of the present invention relates to leukemia of the subtypes chronic lymphocytic leukemia and acute myelogen leukemia. More specifically the present invention relates to AML with 11Q23/MLL translocation. Thus, in one embodiment of the present invention is the NHL cancer AML with 11Q23/MLL translocation.
General
[0271] It should be understood that any feature and/or aspect discussed above in connections with the compounds and particles according to the invention apply by analogy to the methods and applications described herein.
[0272] The following figures and examples are provided below to illustrate the present invention. They are intended to be illustrative and are not to be construed as limiting in any way.
EXAMPLES
Example 1—Clinical Study on .SUP.177.Lu-Lilotomab Satetraxetan
Materials and Methods
[0273] Betalutin is an antibody-radionuclide-conjugate (ARC) composed of the radioisotope lutetium-177, the linker benzyl-DOTA and the murine anti-CD37 IgG1 antibody, lilotomab. The active moiety is the beta particle emitting nuclide .sup.177Lu. Lutetium-177 has physical half-life of 6.7 days. The antibody lilotomab recognises epitopes on the CD37 antigen, which is abundant on the cell surface of tumours of B-cell origin, including NHL. Betalutin is prepared as a solution for intravenous administration. 1 mg/ml lilotomab antibody will be used, between 7 to 20 mg lilotomab antibody per patient. The amount of lutetium (.sup.177Lu)-lilotomab satetraxetan injected per patient will depend on dose level and patient's weight; however, the dose is capped for patients who weigh more than 130 kg (patients heavier than 130 kg will receive the dose for a 130 kg patient). Betalutin are supplied in vials containing a ready to use solution.
[0274] The investigational medicinal product will be referred to as Betalutin or lutetium (.sup.177Lu)-lilotomab satetraxetan in the protocol.
[0275] Rituximab (MabThera) is used as pre-treatment. Rituximab, a chimeric anti-CD20 antibody will be used to clear the circulating normal peripheral B-lymphocytes in the blood and in the spleen before administrating CD37 targeting Betalutin. This may secure better access for Betalutin to less accessible compartments such as lymph nodes and larger tumour masses. Rituximab targets CD20 and will not block the binding of Betalutin CD37 on the B-lymphocytes or tumour cells. Betalutin contains a murine monoclonal antibody which has been shown from in vitro analysis to bind to the human Fc-γ receptor Ha. While rituximab binds to CD20 it also binds to the Fc-γ receptor Ha and if administered just prior to Betalutin may therefore inhibit the binding of Betalutin to this receptor and improve its biodistribution. Arm 3 has therefore been included in the study via a protocol amendment to test the ability of rituximab to improve the biodistribution of Betalutin. This improved biodistribution may reduce the incidence of myleosuppressive adverse events by decreasing the radioactivity in the bone marrow and spleen.
[0276] In Phase I arms 1, 2, and Phase II, two intravenous infusions of 375 mg/m.sup.2 rituximab have been given, at 28 Days and 21 Days, before administration of Betalutin. In Phase I, arms 3, 4 and 5, one intravenous infusion of 375 mg/m.sup.2 rituximab have been given 14 days before, and in arms 3 and 5 an additional intravenous infusion of 375 mg/m.sup.2 rituximab will be given within 4 hours before Betalutin administration on Day 0. Pre-medication consisting of an antipyretic and antihistamine medication should be administered before infusion of rituximab. The types of pre-medication are in accordance with each hospital's routine, including any use of corticosteroids.
[0277] Lilotomab is used as pre-dosing. The same antibody, lilotomab, as used in Betalutin, a murine anti-CD37 antibody, is used to block the binding on remaining B-cells, after rituximab treatment, in the lymphoid organs. One intravenous infusion of 40 mg lilotomab in arm 1, and 100 mg/m.sup.2 lilotomab in arm 4 and arm 5, is performed within 4 hours before administration of Betalutin (up to a maximum of 2.7 m.sup.2 for lilotomab in arm 4 and 5). Pre-medication consisting of an antipyretic and antihistamine medication should be administered before infusion of lilotomab.
[0278] Betalutin is administered in a dose of 15-20 Mbq/kg. Arm 4 is 15 Mbq/kg.
[0279] An example of administration pattern can be seen in
TABLE-US-00001 TABLE 1 Composition of Betalutin Solution for Injection REFERENCE COMPOSITION FOR QUANTITY TO THE COMPONENTS PER ML FUNCTION STANDARDS Drug Substance Lutetium (.sup.177Lu) 0.75 mg Drug substance GMP lilotomab satetraxetan manufactured Ammonium acetate 0.46 mg pH adjustment Ph. Eur. HCl.sup.3 Trace Solvent for .sup.177Lu Ph. Eur./USP Formulation Buffer Sodium ascorbate 30.86 mg Radiolytic USP scavenger DTPA 0.31 mg Chelation of USP free .sup.177Lu NaOH 0.17 mg pH adjustment Ph. Eur./ USP-NF Recombinant human 60.82 mg Stabiliser/ USP/NF albumin radioprotectant Sodium dihydrogen 3.32 mg Buffer USP/BP phosphate monohydrate Sodium chloride 4.34 mg Osmolyte USP
TABLE-US-00002 TABLE 2 Composition of lilotomab Drug Product AMOUNT REFERENCE COMPONENT PER ML FUNCTION TO STANDARDS Lilotomab drug substance In house. consisting of: Lilotomab 5 mg Active Ingredient Disodium hydrogen 12.7 mg Buffer phosphate dodecahydrate Buffer Sodium dihydrogen 0.7 mg Osmolyte phosphate dihydrate Sodium Chloride 0.5 mg Stabilizer Sucrose 50 mg Stabilizer Polysorbate 20 0.2 mg Solvent WFI Ad 1 mL
Results
[0280] These results are the results of a phase I/II clinical study on humans.
[0281] Platelet and neutrophil counts of arm 3 (rituximab predosing) and arm 4 (100 mg/m.sup.2 lilotomab predosing) show grade 3-4 toxicity of arm 3 and no toxicity of arm 4 (
[0282] The PK profiles show a large separation between the treatment arms. Arm 1=40 mg lilotomab predosing, Arm 2=no predosing, Arm 3=rituximab predosing and Arm 4=100 mg/m.sup.2 lilotomab predosing (
Example 2—Clinical Study on .SUP.177.Lu-Lilotomab Satetraxetan
Materials and Methods
[0283] Materials and methods are the same as in Example 1.
[0284] In Phase I arms 1, 2, and Phase II, two intravenous infusions of 375 mg/m2 rituximab have been given, at 28 Days and 21 Days, before administration of Betalutin (
[0285] Lilotomab is used as pre-dosing. The same antibody, lilotomab, as used in Betalutin, a murine anti-CD37 antibody, is used to block the binding on remaining B-cells, after rituximab treatment, in the lymphoid organs. One intravenous infusion of 40 mg lilotomab in arm 1, and 100 mg/m2 lilotomab in arm 4, is performed within 4 hours before administration of Betalutin (up to a maximum of 2.7 m2 for lilotomab in arm 4 and 5). Pre-medication consisting of an antipyretic and antihistamine medication should be administered before infusion of lilotomab.
[0286] Betalutin is administered in a dose of 15-20 MBq/kg.
[0287] Examples of administration patterns can be seen in
Results
[0288] These results are the results of a phase I/II clinical study on humans.
[0289] Platelet and neutrophil counts of patients in arm 1 (40 mg predosing), arm 2 (no predosing), arm 3 (rituximab predosing) and arm 4 (100 mg/m2 lilotomab predosing) show grade 3-4 toxicity of arm 2 and 3, less toxicity of arm 1 and no toxicity of arm 4 (
[0290] The PK profiles show a large separation between the treatment arms. Arm 1=40 mg lilotomab predosing, Arm 2=no predosing, Arm 3=rituximab predosing and Arm 4=100 mg/m2 lilotomab predosing (
[0291] The mean values for platelets and neutrophils at nadir for 23 arm 1 patients were lower than the mean values for 3 arm 4 patients (
[0292] The dose limiting toxicity and number of grade 3 and 4 adverse events were lower for arm 4 than for arm 1 and highest for arm 2 (
Example 3—Pre-Dosing with Lilotomab Prior to Treatment with .SUP.177.Lu-Lilotomab Satetraxetan Significantly Increases the Ratio of Tumour to Red Marrow Absorbed Dose in Non-Hodgkin Lymphoma Patients
Aim:
[0293] Four different combinations of pre-dosing and pre-treatment have been investigated. All patients were pre-treated with different regimens of rituximab. Two arms included cold lilotomab pre-dosing (arm 1 and 4; 40 mg fixed and 100 mg/m.sup.2 Body Surface Area dosage, respectively) and two did not (arm 2 and 3). Patients received either 10, 15 or 20 MBq .sup.177Lu-lilotomab satetraxetan per kg body weight. Previously, we have shown that absorbed red marrow (RM) doses were lower in arm 1 vs arm 2, and that haematological toxicity was more severe for patients receiving higher RM doses. The aim of this work was to compare the ratios of tumour to RM absorbed doses between arm 1, 4 and non-pre-dosed patients (arm 2+3).
Materials and Methods:
[0294] A total of 16 patients were included for RM dosimetry, of these were 14 included for tumour dosimetry. A total of 35 tumours were included, 1 to 5 from each patient (mode 3). RM and mean tumour absorbed doses per administered activity were determined from multiple SPECT/CT-images for each patient. Two-sided student-t-tests were used for all statistical analyses.
Results:
[0295] The mean RM absorbed doses were 0.83, 0.91 and 1.39 mGy/MBq for arm 1, 4 and non-pre-dosing respectively. There was a significantly higher RM dose for non-pre-dosing compared to arm 1 (p=0.04), and arm 4 (p=0.05). Mean tumour absorbed doses were 1.62, 2.78 and 1.37 mGy/MBq for arm 1, 4 and non-pre-dosing respectively. Tumour doses were higher in arm 4 patients compared to patients without pre-dosing (p=0.04). Tumour doses in arm 1 were not significantly higher compared to non-pre-dosing (p=0.71). The mean tumour to RM absorbed dose ratios were 2.16, 3.93 and 1.07 for arm 1, 4 and non-pre-dosing respectively. Ratios were significantly higher in both arm 1 and 4 compared to non-pre-dosing (p=0.05 and p=0.04). No statistically significant difference between arm 1 and 4 was found for any parameters (p>=0.12).
Conclusion:
[0296] Pre-dosing with lilotomab has a mitigating effect on red marrow absorbed dose for .sup.177Lu-lilotomab satetraxetan patients, and increased amounts was found correlated with a higher tumour dose. Both pre-dosage levels significantly increased the tumour to RM absorbed dose ratio.
Example 4—Efficacy and Hematological Toxicity of .SUP.177.Lu-Lilotomab Satetraxetan in Non-Hodgkin Lymphoma Patients
Aim:
[0297] Four different combinations of pre-dosing and pre-treatment have been investigated. All patients were pre-treated with different regimens of 375 mg/m.sup.2 rituximab. The patients were enrolled into four dose-escalation arms:
[0298] Arm 1: .sup.177Lu-lilotomab satetraxetan+pre-dosing with 40 mg lilotomab (cold anti-CD37 Ab)
[0299] Arm 2: .sup.177Lu-lilotomab satetraxetan without pre-dosing
[0300] Arm 3: .sup.177Lu-lilotomab satetraxetan+pre-dosing with 375 mg/m2 rituximab
[0301] Arm 4: .sup.177Lu-lilotomab satetraxetan+pre-dosing with 100 mg/m2 lilotomab
[0302] Patients received either 10, 15 or 20 MBq .sup.177Lu-lilotomab satetraxetan per kg body weight. The aim of this work was to determine the therapeutic efficacy and hematological toxicity of each study arm.
[0303] After finding the maximum tolerable dose (MTD), arm 1 was continued into a phase 2 part to evaluate efficacy in a larger data-set.
Patients and Methods:
[0304] The key eligibility criteria was: 1) Age≥18 with histologically confirmed relapsed indolent B-cell NHL (follicular grade I-IIIA, mantle cell, SLL, marginal zone, lymphoplasmacytic subtypes). 2) <25% bone marrow involvement. 3) Life expectancy months. 4) Platelet count>150×10.sup.9/L. 5) ANC≥1.5×10.sup.9/L. 6) No previous hematopoietic stem cell transplantation.
[0305] Dose-limiting toxicities (DLTs) were assessed during the first 12 weeks. Incidence and severity of adverse events (AEs) according to common terminology criteria for adverse events (CTCAE) v4.0. Response assessments were conducted at 3, 6 (FDG PET-CT), 9, 12, 18, 24 and 36 months (CT) per the International Working Group (IWG) criteria for NHL.
[0306] A total of 52 patients were included in the different arms and dose groups according to Table 3.
TABLE-US-00003 TABLE 3 Distribution of patient in different study arms and dose groups 10 MBq/kg 15 MBq/kg 20 MBq/kg Total Arm 1 4 29 3 36 Arm 2 1 2 0 3 Arm 3 0 3 0 3 Arm 4 0 3 7 10 Total 5 27 10 52
Safety
[0307] Overall, .sup.177Lu-lilotomab satetraxetan was well-tolerated. The most common grade 3/4 adverse events were reversible thrombocytopenia and neutropenia. No grade 4 neutropenia/thrombocytopenia was observed with higher lilotomab pre-dosing and 100 mg/m.sup.2 gave a higher bone marrow protection than 40 mg (
Efficacy
[0308] Overall, objective responses were observed in 33 of 52 (63%) patients. 13 patients (25%) achieved a CR (Table 4). Significant activity was seen in patients with relapsed follicular lymphoma (FL) (ORR 70%; CR 24%). The ORR of arm 1, 2 and 3 were similar, while the ORR of arm 4 was lower. There was, however, too few patients in arm 2, 3 and 4 to draw any firm conclusions.
TABLE-US-00004 TABLE 4 Overall response rate (ORR), complete response (CR), partial response (PR), stable disease (SD) and progressive disease (PD) of patients treated with 177Lu-lilotomab satetraxetan Best Response Arm 1 Arm 2 Arm 3 Arm 4 Total Activity (MBq/kg) 10 15 20 10 15 15 15 20 n 4 29 3 1 2 3 3 7 52 ORR (CR + PR) 2 20 3 1 1 2 1 3 33 (50%) (69%) (100%) (100%) (50%) (67%) (33%) (43%) (63%) CR 0 9 2 0 0 0 1 1 13 (31%) (67%) (33%) (14%) (25%) PR 2 11 1 1 1 2 0 2 20 (50%) (38%) (33%) (100%) (50%) (67%) (29%) (38%) SD 1 3 0 0 1 0 1 3 9 (25%) (10%) (50%) (33%) (43%) (17%) PD 1 4 0 0 0 1 1 1 10 (25%) (17%) (33%) (33%) (14%) (19%)
Conclusion:
[0309] The hematological toxicity was reduced by pre-dosing with lilotomab.
Items
[0310] 1. .sup.177Lu-lilotomab satetraxetan for use the treatment of Non-Hodgkin lymphoma, wherein .sup.177Lu-lilotomab satetraxetan is administered according to an administration pattern comprising:
a) predosing of 20-250 mg/m.sup.2 lilotomab, followed by
b) 10-50 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0311] 2. .sup.177Lu-lilotomab satetraxetan for use in the treatment of Non-Hodgkin lymphoma according to item 1, wherein .sup.177Lu-lilotomab satetraxetan is administered at a concentration selected from the group consisting of 10, 12.5, 15, 17.5, 20, 25, 30, 35, 40, 45 and 50 MBq/kg.
[0312] 3. .sup.177Lu-lilotomab satetraxetan for use in the treatment of Non-Hodgkin lymphoma according to any one of items 1-2, wherein .sup.177Lu-lilotomab satetraxetan is administered at a concentration 15 MBq/kg.
[0313] 4. .sup.177Lu-lilotomab satetraxetan for use in the treatment of Non-Hodgkin lymphoma according to any one of items 1-3, wherein .sup.177Lu-lilotomab satetraxetan is administered at a concentration 17.5 MBq/kg.
[0314] 5. .sup.177Lu-lilotomab satetraxetan for use in the treatment of Non-Hodgkin lymphoma according to any one of items 1-4, wherein .sup.177Lu-lilotomab satetraxetan is administered at a concentration 20 MBq/kg.
[0315] 6. .sup.177Lu-lilotomab satetraxetan for use in the treatment of Non-Hodgkin lymphoma according to any one of items 1-5, wherein lilotomab is administered at a concentration selected from the group consisting of 20 mg/m.sup.2, 40 mg/m.sup.2, 50 mg/m.sup.2, 60 mg/m.sup.2, 75 mg/m.sup.2, 100 mg/m.sup.2, 125 mg/m.sup.2, 150 mg/m.sup.2, 200 mg/m.sup.2, 250 mg/m.sup.2, 20 mg/patient and 40 mg/patient.
[0316] 7. .sup.177Lu-lilotomab satetraxetan for use in the treatment of Non-Hodgkin lymphoma according to any one of items 1-6, wherein lilotomab is administered at 20 mg/m2.
[0317] 8. .sup.177Lu-lilotomab satetraxetan for use in the treatment of Non-Hodgkin lymphoma according to any one of items 1-7, wherein lilotomab is administered at 40 mg/m.sup.2.
[0318] 9. .sup.177Lu-lilotomab satetraxetan for use in the treatment of Non-Hodgkin lymphoma according to any one of items 1-8, wherein lilotomab is administered at 60 mg/m.sup.2.
[0319] 10. .sup.177Lu-lilotomab satetraxetan for use in the treatment of Non-Hodgkin lymphoma according to any one of items 1-8, wherein lilotomab is administered at 100 mg/m.sup.2.
[0320] 11. .sup.177Lu-lilotomab satetraxetan for use in the treatment of Non-Hodgkin lymphoma according to any one of items 1-9, wherein lilotomab is administered at 20 mg/patient.
[0321] 12. .sup.177Lu-lilotomab satetraxetan for use in the treatment of Non-Hodgkin lymphoma according to any one of items 1-9, wherein lilotomab is administered at 40 mg/patient.
[0322] 13. .sup.177Lu-lilotomab satetraxetan for use in the treatment of Non-Hodgkin lymphoma according to any one of items 1-12, wherein the predosing of lilotomab is done less than 24 hours, such as within 4 hours before administration of .sup.177Lu-lilotomab satetraxetan.
[0323] 14. .sup.177Lu-lilotomab satetraxetan for use in the treatment of Non-Hodgkin lymphoma according to any one of items 1-13, further comprising a pretreatment step before step a), wherein the pretreatment step comprises pretreatment with one, two, three or more administrations of 375 mg/m.sup.2 rituximab.
[0324] 15. .sup.177Lu-lilotomab satetraxetan for use in the treatment of Non-Hodgkin lymphoma according to item 14, wherein 375 mg/m.sup.2 rituximab is administered at 28 and 21 days before administration of .sup.177Lu-lilotomab satetraxetan.
[0325] 16. .sup.177Lu-lilotomab satetraxetan for use in the treatment of Non-Hodgkin lymphoma according to item 14, wherein 375 mg/m.sup.2 rituximab is administered at 14 days before administration of .sup.177Lu-lilotomab satetraxetan.
[0326] 17. .sup.177Lu-lilotomab satetraxetan for use in the treatment of Non-Hodgkin lymphoma according to items 14 and 16, wherein 375 mg/m.sup.2 rituximab is infused at 14 days before and again less than 4 hours before administration of .sup.177Lu-lilotomab satetraxetan.
[0327] 18. .sup.177Lu-lilotomab satetraxetan for use in the treatment of Non-Hodgkin lymphoma according to any one of items 1-17, wherein the lymphoma is a subtype selected from the group consisting of follicular grade I-IIIA, marginal zone, small lymphocytic, lymphoplasmacytic, AML, CLL, BLBCL, AML with 11Q23/MLL translocation, and mantle cell.
[0328] 19. .sup.177Lu-lilotomab satetraxetan for use in the treatment of Non-Hodgkin lymphoma according to any one of items 1-12, wherein the patient is relapsing after treatment with rituximab.
[0329] 20. Lilotomab for use in the treatment of Non-Hodgkin lymphoma wherein lilotomab is administered according to an administration pattern comprising:
[0330] a) predosing of 20-250 mg/m.sup.2 lilotomab, followed by
[0331] b) 10-50 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0332] 21. Lilotomab for use in the treatment of Non-Hodgkin lymphoma wherein lilotomab is administered according to an administration pattern comprising:
[0333] a) predosing of 20-100 mg/m.sup.2 lilotomab, followed by
[0334] b) 10-20 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0335] 22. Lilotomab for use in the treatment of Non-Hodgkin lymphoma wherein lilotomab is administered according to item 20-21, wherein .sup.177Lu-lilotomab satetraxetan is administered at a concentration 10 MBq/kg.
[0336] 23. Lilotomab for use in the treatment of Non-Hodgkin lymphoma wherein lilotomab is administered according to item 20-21, wherein .sup.177Lu-lilotomab satetraxetan is administered at a concentration 15 MBq/kg.
[0337] 24. Lilotomab for use in the treatment of Non-Hodgkin lymphoma wherein lilotomab is administered according to items 20-20, wherein .sup.177Lu-lilotomab satetraxetan is administered at a concentration 17.5 MBq/kg.
[0338] 25. Lilotomab for use in the treatment of Non-Hodgkin lymphoma wherein lilotomab is administered according to items 20-21, wherein .sup.177Lu-lilotomab satetraxetan is 3 administered at a concentration 20 MBq/kg.
[0339] 26. Lilotomab for use in the treatment of Non-Hodgkin lymphoma wherein lilotomab is administered according to items 20-21, wherein lilotomab is administered at 20 mg/m.sup.2.
[0340] 27. Lilotomab for use in the treatment of Non-Hodgkin lymphoma wherein lilotomab is administered according to items 20-21, wherein lilotomab is administered at 40 mg/m.sup.2.
[0341] 28. Lilotomab for use in the treatment of Non-Hodgkin lymphoma wherein lilotomab is administered according to items 20-21, wherein lilotomab is administered at 60 mg/m.sup.2.
[0342] 29. Lilotomab for use in the treatment of Non-Hodgkin lymphoma wherein lilotomab is administered according to items 20-21, wherein lilotomab is administered at 100 mg/m.sup.2.
[0343] 30. Lilotomab for use in the treatment of Non-Hodgkin lymphoma wherein lilotomab is administered according to items 20-21, wherein lilotomab is administered at 20 mg/patient.
[0344] 31. Lilotomab for use in the treatment of Non-Hodgkin lymphoma wherein lilotomab is administered according to items 20-21, wherein lilotomab is administered at 40 mg/patient.
[0345] 31. Lilotomab for use in the treatment of Non-Hodgkin lymphoma wherein lilotomab is administered according to items 20-21, wherein lilotomab is administered at 60 mg/kg.
[0346] 31. Lilotomab for use in the treatment of Non-Hodgkin lymphoma wherein lilotomab is administered according to items 20-21, wherein lilotomab is administered at 100 mg/kg.
[0347] 33. Lilotomab for use in the treatment of Non-Hodgkin lymphoma wherein lilotomab is administered according to an administration pattern comprising:
[0348] a) predosing of 40 mg/m.sup.2 lilotomab, followed by
[0349] b) 15 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0350] 34. Lilotomab for use in the treatment of Non-Hodgkin lymphoma wherein lilotomab is administered according to an administration pattern comprising:
[0351] a) predosing of 40 mg/patient lilotomab, followed by
[0352] b) 15 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0353] 35. Lilotomab for use in the treatment of Non-Hodgkin lymphoma wherein lilotomab is administered according to an administration pattern comprising:
[0354] a) predosing of 100 mg/m.sup.2 lilotomab, followed by
[0355] b) 15 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0356] 36. Lilotomab for use in the treatment of Non-Hodgkin lymphoma wherein lilotomab is administered according to an administration pattern comprising:
[0357] a) predosing of 60 mg/m.sup.2 lilotomab, followed by
[0358] b) 10 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0359] 37. Lilotomab for use in the treatment of Non-Hodgkin lymphoma wherein lilotomab is administered according to an administration pattern comprising:
[0360] a) predosing of 60 mg/m.sup.2 lilotomab, followed by
[0361] b) 15 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0362] 38. Lilotomab for use in the treatment of Non-Hodgkin lymphoma wherein lilotomab is administered according to an administration pattern comprising:
[0363] a) predosing of 60 mg/m.sup.2 lilotomab, followed by
[0364] b) 20 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0365] 39. Lilotomab for use in the treatment of Non-Hodgkin lymphoma wherein lilotomab is administered according to an administration pattern comprising:
[0366] a) predosing of 20 mg/patient lilotomab, followed by
[0367] b) 15 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0368] 40. Lilotomab for use in the treatment of Non-Hodgkin lymphoma wherein lilotomab is administered according to an administration pattern comprising:
[0369] a) predosing of 20 mg/patient lilotomab, followed by
[0370] b) 20 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0371] 41. Lilotomab for use in the treatment of Non-Hodgkin lymphoma wherein lilotomab is administered according to an administration pattern comprising:
[0372] a) predosing of 20 mg/m.sup.2 lilotomab, followed by
[0373] b) 15 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0374] 42. Lilotomab for use in the treatment of Non-Hodgkin lymphoma wherein lilotomab is administered according to an administration pattern comprising:
[0375] a) predosing of 100 mg/m.sup.2 lilotomab, followed by
[0376] b) 20 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0377] 43. A combination of lilotomab and .sup.177Lu-lilotomab satetraxetan for use in the treatment of Non-Hodgkin lymphoma wherein lilotomab and .sup.177Lu-lilotomab satetraxetan is administered according to an administration pattern comprising:
[0378] a) predosing of 20-250 mg/m.sup.2 lilotomab, followed by
[0379] b) 10-50 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0380] 44. A combination of lilotomab and .sup.177Lu-lilotomab satetraxetan for use according to item 43, wherein .sup.177Lu-lilotomab satetraxetan is administered at a concentration 10 MBq/kg.
[0381] 45. A combination of lilotomab and .sup.177Lu-lilotomab satetraxetan for use according to item 43, wherein .sup.177Lu-lilotomab satetraxetan is administered at a concentration 15 MBq/kg.
[0382] 46. A combination of lilotomab and .sup.177Lu-lilotomab satetraxetan for use according to item 43, wherein .sup.177Lu-lilotomab satetraxetan is administered at a concentration 17.5 MBq/kg.
[0383] 47. A combination of lilotomab and .sup.177Lu-lilotomab satetraxetan for use according to item 43, wherein .sup.177Lu-lilotomab satetraxetan is administered at a concentration 20 MBq/kg.
[0384] 48. A combination of lilotomab and .sup.177Lu-lilotomab satetraxetan for use according to item 36, wherein lilotomab is administered at 20 mg/m.sup.2.
[0385] 49. A combination of lilotomab and .sup.177Lu-lilotomab satetraxetan for use according to item 36, wherein lilotomab is administered at 40 mg/m.sup.2.
[0386] 50. A combination of lilotomab and .sup.177Lu-lilotomab satetraxetan for use according to item 36, wherein lilotomab is administered at 40 mg/patient.
[0387] 51. A combination of lilotomab and .sup.177Lu-lilotomab satetraxetan for use according to item 36, wherein lilotomab is administered at 100 mg/m.sup.2.
[0388] 52. A combination of lilotomab and .sup.177Lu-lilotomab satetraxetan for use according to item 36, wherein lilotomab is administered at 20 mg/patient.
[0389] 53. A combination of lilotomab and .sup.177Lu-lilotomab satetraxetan for use in the treatment of Non-Hodgkin lymphoma wherein lilotomab and .sup.177Lu-lilotomab satetraxetan is administered according to an administration pattern comprising:
[0390] a) predosing of 40 mg/m.sup.2 lilotomab, followed by
[0391] b) 15 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0392] 54. A combination of lilotomab and .sup.177Lu-lilotomab satetraxetan for use in the treatment of Non-Hodgkin lymphoma wherein lilotomab and .sup.177Lu-lilotomab satetraxetan is administered according to an administration pattern comprising:
[0393] a) predosing of 40 mg/patient lilotomab, followed by
[0394] b) 15 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0395] 55. A combination of lilotomab and .sup.177Lu-lilotomab satetraxetan for use in the treatment of Non-Hodgkin lymphoma wherein lilotomab and .sup.177Lu-lilotomab satetraxetan is administered according to an administration pattern comprising:
[0396] a) predosing of 100 mg/m.sup.2 lilotomab, followed by
[0397] b) 15 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0398] 56. A combination of lilotomab and .sup.177Lu-lilotomab satetraxetan for use in the treatment of Non-Hodgkin lymphoma wherein lilotomab and .sup.177Lu-lilotomab satetraxetan is administered according to an administration pattern comprising:
[0399] a) predosing of 100 mg/m.sup.2 lilotomab, followed by
[0400] b) 20 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0401] 57. Lilotomab for use in the reduction of haematological toxicity due to the administration of .sup.177Lu-lilotomab satetraxetan, wherein lilotomab is administered before .sup.177Lu-lilotomab satetraxetan in a dose of 20-250 mg/m.sup.2.
[0402] 58. Lilotomab for use in the reduction of haematological toxicity due to the administration of .sup.177Lu-lilotomab satetraxetan according to item 57, wherein lilotomab is administered before .sup.177Lu-lilotomab satetraxetan in a dose of 40 mg/m.sup.2.
[0403] 59. Lilotomab for use in the reduction of haematological toxicity due to the administration of .sup.177Lu-lilotomab satetraxetan according to item 57, wherein lilotomab is administered before .sup.177Lu-lilotomab satetraxetan in a dose of 40 mg/patient.
[0404] 60. Lilotomab for use in the reduction of haematological toxicity due to the administration of .sup.177Lu-lilotomab satetraxetan according to item 57, wherein lilotomab is administered before .sup.177Lu-lilotomab satetraxetan in a dose of 100 mg/m.sup.2.
[0405] 61. Lilotomab for use in the reduction of haematological toxicity due to the administration of .sup.177Lu-lilotomab satetraxetan according to item 57, wherein lilotomab is administered before .sup.177Lu-lilotomab satetraxetan in a dose of 60 mg/m.sup.2.
[0406] 62. Lilotomab for use in the reduction of haematological toxicity due to the administration of .sup.177Lu-lilotomab satetraxetan according to items 57-61, wherein .sup.177Lu-lilotomab satetraxetan is administered in a dose of 15 MBq/kg.
[0407] 63. Lilotomab for use in the reduction of haematological toxicity due to the administration of .sup.177Lu-lilotomab satetraxetan according to items 57-61, wherein .sup.177Lu-lilotomab satetraxetan is administered in a dose of 17.5 MBq/kg.
[0408] 64. Lilotomab for use in the reduction of haematological toxicity due to the administration of .sup.177Lu-lilotomab satetraxetan according to items 57-61, wherein .sup.177Lu-lilotomab satetraxetan is administered in a dose of 20 MBq/kg.
[0409] 65. Lilotomab for use in the reduction of haematological toxicity due to the administration of 15 MBq/kg .sup.177Lu-lilotomab satetraxetan, wherein lilotomab is administered before .sup.177Lu-lilotomab satetraxetan in a dose of 40 mg/m.sup.2.
[0410] 66. Lilotomab for use in the reduction of haematological toxicity due to the administration of 15 MBq/kg .sup.177Lu-lilotomab satetraxetan, wherein lilotomab is administered before .sup.177Lu-lilotomab satetraxetan in a dose of 40 mg/patient.
[0411] 67. Lilotomab for use in the reduction of haematological toxicity due to the administration of 15 MBq/kg .sup.177Lu-lilotomab satetraxetan, wherein lilotomab is administered before .sup.177Lu-lilotomab satetraxetan in a dose of 100 mg/m.sup.2.
[0412] 68. Lilotomab for use in the reduction of haematological toxicity due to the administration of 20 MBq/kg .sup.177Lu-lilotomab satetraxetan, wherein lilotomab is administered before .sup.177Lu-lilotomab satetraxetan in a dose of 100 mg/m.sup.2.
[0413] 69. Lilotomab for use in the reduction of haematological toxicity due to the administration of 20 MBq/kg .sup.177Lu-lilotomab satetraxetan, wherein lilotomab is administered before .sup.177Lu-lilotomab satetraxetan in a dose of 40 mg/patient.
[0414] 70. Lilotomab for use in the reduction of haematological toxicity due to the administration of 17.5 MBq/kg .sup.177Lu-lilotomab satetraxetan, wherein lilotomab is administered before .sup.177Lu-lilotomab satetraxetan in a dose of 40 mg/patient.
[0415] 71. Lilotomab for use in the reduction of haematological toxicity due to the administration of 15 MBq/kg .sup.177Lu-lilotomab satetraxetan, wherein lilotomab is administered before .sup.177Lu-lilotomab satetraxetan in a dose of 40 mg/patient.
[0416] 72. Lilotomab for use in the reduction of haematological toxicity due to the administration of 15 MBq/kg .sup.177Lu-lilotomab satetraxetan, wherein lilotomab is administered before .sup.177Lu-lilotomab satetraxetan in a dose of 100 mg/m.sup.2.
[0417] 73. Lilotomab for use in the reduction of haematological toxicity due to the administration of 17.5 MBq/kg .sup.177Lu-lilotomab satetraxetan, wherein lilotomab is administered before .sup.177Lu-lilotomab satetraxetan in a dose of 100 mg/m.sup.2.
[0418] 74. Lilotomab for use in the reduction of haematological toxicity due to the administration of 20 MBq/kg .sup.177Lu-lilotomab satetraxetan, wherein lilotomab is administered before .sup.177Lu-lilotomab satetraxetan in a dose of 100 mg/m.sup.2.
[0419] 75. Lilotomab for use in the reduction of haematological toxicity due to the administration of 10 MBq/kg .sup.177Lu-lilotomab satetraxetan, wherein lilotomab is administered before .sup.177Lu-lilotomab satetraxetan in a dose of 60 mg/m.sup.2.
[0420] 76. Lilotomab for use in the reduction of haematological toxicity due to the administration of 15 MBq/kg .sup.177Lu-lilotomab satetraxetan, wherein lilotomab is administered before .sup.177Lu-lilotomab satetraxetan in a dose of 60 mg/m.sup.2.
[0421] 77. Lilotomab for use in the reduction of haematological toxicity due to the administration of 20 MBq/kg .sup.177Lu-lilotomab satetraxetan, wherein lilotomab is administered before .sup.177Lu-lilotomab satetraxetan in a dose of 60 mg/m.sup.2.
[0422] 78. A method of treating Non-Hodgkin lymphoma comprising administration of .sup.177Lu-lilotomab satetraxetan in an administration pattern comprising:
[0423] a) predosing of 20-250 mg/m.sup.2 lilotomab, followed by
[0424] b) 10-50 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0425] 79. A method of treating Non-Hodgkin lymphoma comprising administration of .sup.177Lu-lilotomab satetraxetan in an administration pattern comprising:
[0426] a) predosing of 20-500 mg/m.sup.2 lilotomab, followed by
[0427] b) 10-50 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0428] 80. A method of treating Non-Hodgkin lymphoma comprising administration of .sup.177Lu-lilotomab satetraxetan in an administration pattern comprising:
[0429] a) predosing of 40 mg/m.sup.2 lilotomab, followed by
[0430] b) 15 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0431] 81. A method of treating Non-Hodgkin lymphoma comprising administration of .sup.177Lu-lilotomab satetraxetan in an administration pattern comprising:
[0432] a) predosing of 40 mg/patient lilotomab, followed by
[0433] b) 15 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0434] 80. A method of treating Non-Hodgkin lymphoma comprising administration of .sup.177Lu-lilotomab satetraxetan in an administration pattern comprising:
[0435] a) predosing of 100 mg/m.sup.2 lilotomab, followed by
[0436] b) 15 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0437] 83. A method of treating Non-Hodgkin lymphoma comprising administration of .sup.177Lu-lilotomab satetraxetan in an administration pattern comprising:
[0438] a) predosing of 100 mg/m.sup.2 lilotomab, followed by
[0439] b) 20 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0440] 84. .sup.177Lu-lilotomab satetraxetan for use the treatment of Non-Hodgkin lymphoma, wherein .sup.177Lu-lilotomab satetraxetan is administered according to an administration pattern comprising:
[0441] 0) pretreatment with 375 mg/m.sup.2 rituximab administered at 14 days before administration of .sup.177Lu-lilotomab satetraxetan,
[0442] a) predosing of 100 mg/m.sup.2 lilotomab less than 4 hours before administration of .sup.177Lu-lilotomab satetraxetan, followed by
[0443] b) 15 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0444] 85. .sup.177Lu-lilotomab satetraxetan for use the treatment of Non-Hodgkin lymphoma, wherein .sup.177Lu-lilotomab satetraxetan is administered according to an administration pattern comprising:
[0445] 0) pretreatment with 375 mg/m.sup.2 rituximab administered at 14 days before administration of .sup.177Lu-lilotomab satetraxetan,
[0446] a) predosing of 100 mg/m.sup.2 lilotomab less than 4 hours before administration of .sup.177Lu-lilotomab satetraxetan, followed by
[0447] b) 20 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0448] 86. .sup.177Lu-lilotomab satetraxetan for use the treatment of Non-Hodgkin lymphoma, wherein .sup.177Lu-lilotomab satetraxetan is administered according to an administration pattern comprising:
[0449] 0) pretreatment with 375 mg/m.sup.2 rituximab administered at 14 days before administration of .sup.177Lu-lilotomab satetraxetan,
[0450] a) predosing of 100 mg/m.sup.2 lilotomab less than 4 hours before administration of .sup.177Lu-lilotomab satetraxetan, followed by
[0451] b) 25 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0452] 87. .sup.177Lu-lilotomab satetraxetan for use the treatment of Non-Hodgkin lymphoma, wherein .sup.177Lu-lilotomab satetraxetan is administered according to an administration pattern comprising:
[0453] 0) pretreatment with 375 mg/m.sup.2 rituximab administered at 14 days before administration of .sup.177Lu-lilotomab satetraxetan,
[0454] a) predosing of 100 mg/m.sup.2 lilotomab less than 4 hours before administration of .sup.177Lu-lilotomab satetraxetan, followed by
[0455] b) 30 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0456] 88. .sup.177Lu-lilotomab satetraxetan for use the treatment of Non-Hodgkin lymphoma, wherein .sup.177Lu-lilotomab satetraxetan is administered according to an administration pattern comprising:
[0457] 0) pretreatment with 375 mg/m.sup.2 rituximab administered at 14 days before administration of .sup.177Lu-lilotomab satetraxetan,
[0458] a) predosing of 60 mg/m.sup.2 lilotomab less than 4 hours before administration of .sup.177Lu-lilotomab satetraxetan, followed by
[0459] b) 15 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0460] 89. .sup.177Lu-lilotomab satetraxetan for use the treatment of Non-Hodgkin lymphoma, wherein .sup.177Lu-lilotomab satetraxetan is administered according to an administration pattern comprising:
[0461] 0) pretreatment with 375 mg/m.sup.2 rituximab administered at 14 days before administration of .sup.177Lu-lilotomab satetraxetan,
[0462] a) predosing of 60 mg/m.sup.2 lilotomab less than 4 hours before administration of .sup.177Lu-lilotomab satetraxetan, followed by
[0463] b) 20 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0464] 90. .sup.177Lu-lilotomab satetraxetan for use the treatment of Non-Hodgkin lymphoma, wherein .sup.177Lu-lilotomab satetraxetan is administered according to an administration pattern comprising:
[0465] 0) pretreatment with 375 mg/m.sup.2 rituximab administered at 14 days before administration of .sup.177Lu-lilotomab satetraxetan,
[0466] a) predosing of 40 mg/m.sup.2 lilotomab less than 4 hours before administration of .sup.177Lu-lilotomab satetraxetan, followed by
[0467] b) 15 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0468] 91. .sup.177Lu-lilotomab satetraxetan for use the treatment of Non-Hodgkin lymphoma, wherein .sup.177Lu-lilotomab satetraxetan is administered according to an administration pattern comprising:
[0469] 0) pretreatment with 375 mg/m.sup.2 rituximab administered at 14 days before administration of .sup.177Lu-lilotomab satetraxetan,
[0470] a) predosing of 40 mg/patient lilotomab less than 4 hours before administration of .sup.177Lu-lilotomab satetraxetan, followed by
[0471] b) 15 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.
[0472] 92. .sup.177Lu-lilotomab satetraxetan for use the treatment of Non-Hodgkin lymphoma, wherein .sup.177Lu-lilotomab satetraxetan is administered according to an administration pattern comprising:
[0473] 0) pretreatment with 375 mg/m.sup.2 rituximab administered at 14 days before administration of .sup.177Lu-lilotomab satetraxetan,
[0474] a) predosing of 40 mg/patient lilotomab less than 4 hours before administration of .sup.177Lu-lilotomab satetraxetan, followed by
[0475] b) 20 MBq/kg .sup.177Lu-lilotomab satetraxetan to a person in need thereof.