Schweitzer Andrew D, Rakesh Vineet, Revskaya Ekaterina, Datta Ashim, Casadevall Arturo, Dadachova Ekaterina
The Mount Sinai School of Medicine, Cornell University, Ithaca, New York, USA.
Melanoma Res. 2007 Oct;17(5):291-303. doi: 10.1097/CMR.0b013e3282eeeae7.
Metastatic melanoma is almost always deadly and new methods of treatment are urgently needed. Recently, we established the feasibility of radioimmunotherapy (RIT) for experimental melanoma in mice using a 188-rhenium (188Re)-labeled monoclonal antibody (mAb) 6D2 (IgM) to melanin. Our objective was to determine the effects of varying tumor melanin concentration and of different diffusivities and lymphatic clearance rates of the normal tissue, on the absorbed dose to the tumor in simulated therapy, in preparation for a clinical trial of RIT for melanoma. Using finite element analysis (FEA), we created a pharmacokinetic model that describes melanin-targeting RIT of a melanoma micrometastasis (1.3-mm radius) imbedded in normal tissue (14.3-mm radius). Our method incorporates antibody plasma kinetics, transcapillary transport, interstitial diffusion, and lymphatic clearance. Michaelis-Menten kinetics was used to model mAb binding to tumor melanin for melanin concentrations of 76, 7.6, 0.76, 0.076, and 0.0076 micromol/l. An absorbed dose was calculated, after accounting for direct and crossfire irradiation, on the basis of a 7.4-GBq intravenous dose of 188Re-6D2. The results showed that penetration of mAb into the tumor was inversely proportional to tumor melanin concentration. Decreased diffusivity and increased lymphatic clearance of the surrounding normal tissue decreased the dose to the tumor. The formation of mAb-melanin complex was remarkably similar within a 1000-fold range of melanin concentration, resulting in total doses of 2840, 2820, 2710, and 1990 cGy being delivered to tumors with melanin concentrations of 76, 7.6, 0.76, and 0.076 micromol/l, respectively. In conclusion, RIT of metastatic melanoma can be effective over a wide range of tumor melanin concentrations. The results can be useful in the design of a clinical trial of melanin-targeting RIT in patients with metastatic melanoma.
转移性黑色素瘤几乎总是致命的,因此迫切需要新的治疗方法。最近,我们利用一种针对黑色素的188铼(188Re)标记单克隆抗体(mAb)6D2(IgM),证实了放射免疫疗法(RIT)用于小鼠实验性黑色素瘤治疗的可行性。我们的目标是确定在模拟治疗中,不同的肿瘤黑色素浓度以及正常组织的不同扩散率和淋巴清除率对肿瘤吸收剂量的影响,为黑色素瘤的RIT临床试验做准备。我们使用有限元分析(FEA)创建了一个药代动力学模型,该模型描述了嵌入正常组织(半径14.3毫米)中的黑色素瘤微转移灶(半径1.3毫米)的黑色素靶向RIT。我们的方法纳入了抗体血浆动力学、跨毛细血管转运、间质扩散和淋巴清除。采用米氏动力学对黑色素浓度为76、7.6、0.76、0.076和0.0076微摩尔/升时mAb与肿瘤黑色素的结合进行建模。在考虑直接照射和交叉照射后,根据静脉注射7.4吉贝可的188Re-6D2剂量计算吸收剂量。结果表明,mAb进入肿瘤的渗透率与肿瘤黑色素浓度成反比。周围正常组织扩散率降低和淋巴清除率增加会降低肿瘤剂量。在黑色素浓度相差1000倍的范围内,mAb-黑色素复合物的形成非常相似,黑色素浓度分别为76、7.6、0.76和0.076微摩尔/升的肿瘤所接受的总剂量分别为2840、2820、2710和1990厘戈瑞。总之,转移性黑色素瘤的RIT在广泛的肿瘤黑色素浓度范围内都可能有效。这些结果有助于设计针对转移性黑色素瘤患者的黑色素靶向RIT临床试验。