Oriuchi N
Dept. of Nuclear Medicine, Gunma University School of Medicine.
Gan To Kagaku Ryoho. 1999 May;26(6):762-7.
Technologies using radiolabeled antibodies have advanced significantly over the past decade, although radioimmunotherapy still requires improvements. This paper describes the implications of nuclear medicine in the management of cancer in terms of detection, staging, and qualification of patients for immunotherapy. The results of a clinical trial performed at our institution using 99mTc-labeled anti-CEA monoclonal antibody are briefly reviewed. Immunoscintigraphy has shown particular promise as a means of whole body imaging in patients with colorectal, breast, or lung cancer, and the antibodies used for diagnostic imaging are now being used for radioimmunotherapy. Radioimmunotherapy of B-cell lymphoma has been successfully performed using 131I or 90Y labeled anti-lymphocyte monoclonal antibodies, although the treatment of solid tumors is still a major difficulty. Elimination of the immune response by generating humanized monoclonal antibodies, which are virtually devoid of immunogenicity, is necessary to allow repeated administration. This is especially true of patients with solid tumors as compared with patients with hematopoietic ones.
在过去十年中，使用放射性标记抗体的技术取得了显著进展，尽管放射免疫疗法仍需改进。本文从癌症检测、分期以及患者免疫治疗资格鉴定等方面阐述了核医学在癌症管理中的意义。简要回顾了在我们机构进行的一项使用99mTc标记的抗CEA单克隆抗体的临床试验结果。免疫闪烁显像作为一种用于结直肠癌、乳腺癌或肺癌患者全身成像的手段显示出了特别的前景，目前用于诊断成像的抗体正被用于放射免疫治疗。使用131I或90Y标记的抗淋巴细胞单克隆抗体已成功进行了B细胞淋巴瘤的放射免疫治疗，尽管实体瘤的治疗仍然是一个主要难题。为了能够重复给药，有必要通过生成几乎没有免疫原性的人源化单克隆抗体来消除免疫反应。与造血系统肿瘤患者相比，实体瘤患者尤其如此。
