DeNardo Gerald L, Sysko Vladimir V, DeNardo Sally J
Radiodiagnosis and Therapy, Division of Hematology/Oncology, University of California Davis Medical Center, Sacramento, CA, USA.
Int J Radiat Oncol Biol Phys. 2006;66(2 Suppl):S46-56. doi: 10.1016/j.ijrobp.2006.06.038.
The most potent method for augmenting the cytocidal power of monoclonal antibody (MAb) treatment is to conjugate radionuclides to the MAb to deliver systemic radiotherapy (radioimmunotherapy; RIT). The antigen, MAb, and its epitope can make a difference in the performance of the drug. Additionally, the radionuclide, radiochemistry, chelator for radiometals and the linker between the MAb and chelator can have a major influence on the performance of drugs (radiopharmaceuticals) for RIT. Smaller radionuclide carriers, such as antibody fragments and mimics, and those used for pretargeting strategies, have been described and evaluated. All of these changes in the drugs and strategies for RIT have documented potential for improved performance and patient outcomes. RIT is a promising new therapy that should be incorporated into the management of patients with B-cell non-Hodgkin's lymphoma (NHL) soon after these patients have proven incurable. Predictable improvements using better drugs, strategies, and combinations with other drugs seem certain to make RIT integral to the management of patients with NHL, and likely lead to cure of currently incurable NHL.
增强单克隆抗体（MAb）治疗细胞杀伤能力的最有效方法是将放射性核素与单克隆抗体结合，以进行全身放射治疗（放射免疫治疗；RIT）。抗原、单克隆抗体及其表位会影响药物的性能。此外，放射性核素、放射化学、放射性金属螯合剂以及单克隆抗体与螯合剂之间的连接体，会对用于RIT的药物（放射性药物）性能产生重大影响。已经描述并评估了较小的放射性核素载体，如抗体片段和模拟物，以及用于预靶向策略的载体。RIT药物和策略的所有这些变化都已证明具有改善疗效和患者预后的潜力。RIT是一种很有前景的新疗法，在B细胞非霍奇金淋巴瘤（NHL）患者被证明无法治愈后，应尽快将其纳入治疗方案。使用更好的药物、策略以及与其他药物联合使用，可预见的改善似乎肯定会使RIT成为NHL患者治疗不可或缺的一部分，并可能治愈目前无法治愈的NHL。
