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Ninety primary melanoma patients were studied to investigate the importance of adopting the simultaneous use of patent blue dye (PBD) and lymphoscintigraphy plus gamma detection probe to locate the sentinel node (SN). In total 135 SNs in 105 basins were visualized preoperatively under a gamma camera after lymphoscintigraphy. When a SN was identified intraoperatively, its radioactivity level and colour were verified and documented. Two of the SNs seen on lymphoscintigraphy were not found. Using PBD 78.52% of the SNs were identified; 95.5% were identified using the gamma detection probe. Using both methods together 98.5% of the SNs were detected. Twenty-two patients (24.4%) had pathologically positive SNs. The surgical learning curve was assessed for the two techniques. The learning curve associated with the methodology was important in finding the SN when using PBD associated with lymphoscintigraphy, but not when the gamma detection probe was used; we found a statistically significant reduction in the percentage of stained SNs found using PBD in the initial 14 SNs biopsied compared with the subsequent 121 nodes. This is important as not all institutions have access to a gamma probe. The time required to identify each SN was documented and analysed. The duration of the procedure was significantly shorter for stained SNs than for non-stained SNs, which support the use of both PBD and the gamma probe. In conclusion, SN biopsy should be performed by surgeons and nuclear medicine doctors in co-operation, both methods being adopted simultaneously to reduce the percentage of procedure failures.

Radio-immunotherapy (RIT) is an effective approach for patients with relapse-refractory NHL. RIT targets radiation to the tumor bulk while limiting exposure of normal tissues. Toxicity is prevalently hematologic, but transient and reversible. 90Y-Ibritumomab Tiuxetan in particular has demonstrated activity in follicular (FL) and Diffuse Large B-Cell (DLBC) NHL, but data are still lacking in MZL. 90Y-Ibritumomab Tiuxetan could offer an alternative option to those pts who relapse or do not respond to conventional treatment. We report efficacy results of a pilot study of 90Y-Ibritumomab Tiuxetan delivered at conventional activity (0,4 mCi/kg) in MZL patients. From May 2004 to July 2007, 15 patients were enrolled. Median age was 57 ys (range 36–83 ys); 9 female and 6 male. Six out of 15 pts had Helicobacter Pylori-negative gastric MALT (mucosa-associated lymphoid tissue) NHL. The remaining 9 pts had non gastric extranodal MZL. At time of treatment 6/15 pts had limited disease (stage I/II), 9/15 disseminated disease (stage III/IV; Ann-Arbor Staging System); bone marrow biopsy showed disease localization in 3/15 pts. Median number of previous therapies received was 2 (0–4): all pts except one had received prior CT, 7 prior Rituximab, 3 prior RT. Toxicities were primarily haematological, as expected, and reversible. Response evaluation was performed two months after 90Y-Ibritumomab Tiuxetan administration by upper gastrointestinal endoscopy with multiple biopsy and endoscopic ultrasonography in gastric NHL and by CT scan in the remaining pts. Ten out of 15 patients are now evaluable for response: 6 CR, 1 uCR, 3 SD. Response are durable: 5 CRs have been maintained for CR at 33, 26, 22, 15 and 14 months, respectively. CONCLUSIONS: 90Y-Ibritumomab Tiuxetan seems to be very active in pts with MZL resistant or refractory to conventional systemic treatment. Its mechanism of action mimics conventional RT already known as valid option in MZL with localized disease. If these preliminary results are confirmed in larger number of patients, one single administration of 90Y-Ibritumomab Tiuxetan delivered at conventional activity (0,4 mCi/kg) could be considered a possible alternative option in the treatment of such indolent disease.

Somatostatin receptors are over-expressed in many tumours, mainly of neuroendocrine origin, thus enabling treatment with somatostatin analogues. Almost a decade of clinical experience of receptor radionuclide therapy with the analogue (90)Y-[DOTA](0)-Tyr(3)-octreotide [(90)Y-DOTATOC] has now been obtained at a few centres of excellence. This review reports on the present state of the art of receptor radionuclide therapy and discusses new perspectives.

Abstract 3713 BACKGROUND: To evaluate clinical activity of 90Y-Ibritumomab Tiuxetan in Extranodal Marginal-Zone Lymphoma. PATIENTS AND METHODS: From May 2004 to April 2011 thirty patients affected by relapsed/refractory Marginal-Zone Lymphoma - arisen at any extranodal site - were enrolled to receive 90Y-Ibritumomab Tiuxetan at the activity of 0,4 mCi/kg. Median age was 57 years (range 36–83 ys); 16 female and 14 male. Thirtheen patients had Helicobacter Pylori-negative gastric Mucosa-Associated Lymphoid tissue Non Hodgkin Lymphoma, while 17 patients had extra-gastric Marginal-Zone Lymphoma. At time of treatment 13 out of 30 patients had disseminated disease (stage III/IV; Ann-Arbor Staging System); 4 patients bone marrow involvement. All patients had received a previous treatment with a maximum of 7. The median number of previous treatments administered - including antibiotics, CT, RT or surgery - was 1 with a maximum of 7; 14/30 had received at least 2 previous treatments, 5 of them more than 3. RESULTS: Toxicities were primarily hematological, as expected, and reversible; infection or febrile neutropenia was observed in 3 patients. Up to now no myelodisplastic syndrome occurred. Overall Response Rate was 90%: twenty-three patients achieved a complete response (77%); partial response occurred in 4 patients (13%), stable disease in 2 patients (7%) and 1 progression (3%). With a median follow-up of 47 months, 2 patients relapsed after complete response; 8 out of 20 complete responses are still responder after > 3 years and 5 patients after > 5 years. CONCLUSIONS: 90Y-Ibritumomab Tiuxetan seems to be active in patients with Extranodal Marginal-Zone Lymphoma resistant or refractory to conventional systemic treatment. These results suggest as a single shot of radioimmunotherapy could represent a possible option for the treatment of relapsed Marginal Zone Lymphoma. Disclosures: No relevant conflicts of interest to declare.