Department of Oncology, Lund University, Sweden.
Cancer Biother Radiopharm. 2012 Mar;27(2):134-40. doi: 10.1089/cbr.2011.1080. Epub 2012 Jan 9.
Fractionation is generally used as a mean to improve radioimmunotherapy (RIT). Since RIT is considered suitable for small-volume disease, the aim of the current study was to investigate whether repeated administration of (177)Lu-labeled mAb BR96 was tolerated and could delay or prevent metastatic disease after complete remission of the tumor obtained by the first administration.
Immunocompetent rats bearing a syngeneic colon carcinoma were first treated with 400 MBq/kg (177)Lu-DOTA-BR96, an activity resulting in complete response in 29 of 30 animals. On day 21, two groups of rats were given an additional activity of 150 or 350 MBq/kg resulting in total administered activities corresponding to 0.9 and 1.3 times the maximal tolerated dose.
The additional treatment resulted in tolerable myelotoxicity; however, the frequency of metastatic disease and survival were not affected. Immunohistochemistry demonstrated binding of the BR96 antibody to tissue sections of analyzed metastases.
In our model, development of metastatic disease after treatment of the manifest tumor was not prevented by an additional treatment with the same radioimmunoconjugate. Therefore, the antibody should be labeled with a more suitable radionuclide for treatment of metastases. The repeated targeted therapy was well tolerated in aspects of myelotoxicity.
分割治疗通常被用作提高放射免疫治疗(RIT)的手段。由于 RIT 被认为适用于小体积疾病,因此本研究的目的是研究重复给予(177)Lu 标记的单克隆抗体 BR96 是否耐受,以及在首次给药获得肿瘤完全缓解后,是否能延迟或预防转移疾病。
免疫功能正常的大鼠携带同种异体结肠癌细胞,首先给予 400 MBq/kg(177)Lu-DOTA-BR96,该活性导致 30 只动物中的 29 只完全反应。第 21 天,两组大鼠分别给予 150 或 350 MBq/kg 的额外活性,总给予的活性分别相当于最大耐受剂量的 0.9 和 1.3 倍。
额外的治疗导致可耐受的骨髓毒性;然而,转移疾病的频率和生存没有受到影响。免疫组织化学显示 BR96 抗体与分析的转移组织切片结合。
在我们的模型中,在用相同的放射免疫偶联物治疗明显肿瘤后,并未预防转移疾病的发展。因此,该抗体应该用更适合治疗转移的放射性核素进行标记。重复靶向治疗在骨髓毒性方面具有良好的耐受性。