Department of Medical Radiation Physics, Lund University, Lund, Sweden.
J Nucl Med. 2013 Aug;54(8):1404-10. doi: 10.2967/jnumed.112.117028. Epub 2013 Jun 26.
The therapeutic effect of radioimmunotherapy depends on the distribution of the absorbed dose in relation to viable cancer cells within the tumor, which in turn is a function of the activity distribution. The aim of this study was to investigate the distribution of (177)Lu-DOTA-BR96 monoclonal antibodies targeting the Lewis Y antigen over 7 d using a syngeneic rat model of colon carcinoma.
Thirty-eight tumor-bearing rats were intravenously given 25 or 50 MBq of (177)Lu-DOTA-BR96 per kilogram of body weight and were sacrificed 2, 8, 24, 48, 72, 96, 120, or 168 h after injection, with activity measured in blood and tumor samples. Adjacent cryosections of each tumor were analyzed in 3 ways: imaging using a silicon-strip detector for digital autoradiography, staining for histologic characterization, or staining to determine the distribution of the antigen, vasculature, and proliferating cells using immunohistochemistry. Absorbed-dose rate distribution images at the moment of sacrifice were calculated using the activity distribution and a point-dose kernel. The correlations between antigen expression and both activity uptake and absorbed-dose rate were calculated for several regions of interest in each tumor. Nine additional animals with tumors were given unlabeled antibody to evaluate possible immunologic effects.
At 2-8 h after injection, activity was found in the tumor margins; at 24 h, in viable antigen-expressing areas within the tumor; and at 48 h and later, increasingly in antigen-negative areas of granulation tissue. The correlation between antigen expression and both the mean activity and the absorbed-dose rate in regions of interest changed from positive to negative after 24 h after injection. Antigen-negative areas also increased over time in animals injected with unlabeled BR96, compared with untreated tumors.
The results indicate that viable Lewis Y-expressing tumor cells are most efficiently treated during the initial uptake period. The activity then seems to remain in these initial uptake regions after the elimination of tumor cells and formation of granulation tissue. Further studies using these techniques could aid in determining the effects of the intratumoral activity distribution on overall therapeutic efficacy.
本研究旨在使用结肠癌细胞同系大鼠模型,研究 7 天内(177)Lu-DOTA-BR96 单克隆抗体针对 Lewis Y 抗原的分布情况。
38 只荷瘤大鼠分别按 25 或 50MBq/kg 体重静脉注射(177)Lu-DOTA-BR96,在注射后 2、8、24、48、72、96、120 或 168 小时处死,分别测量血样和肿瘤样本中的放射性活度。对每个肿瘤的相邻冷冻切片进行 3 种分析:使用硅条探测器进行数字放射自显影的成像、用于组织学特征鉴定的染色,或用于确定抗原、脉管系统和增殖细胞分布的免疫组织化学染色。使用放射性活度分布和点剂量核函数,在处死时计算吸收剂量率分布图像。计算每个肿瘤的多个感兴趣区域中抗原表达与放射性活度摄取和吸收剂量率之间的相关性。另外 9 只带有肿瘤的动物接受了未标记的抗体,以评估可能的免疫效应。
注射后 2-8 小时,肿瘤边缘有放射性活度;24 小时时,肿瘤内抗原表达的存活区域有放射性活度;48 小时后,肉芽组织中抗原阴性区域的放射性活度逐渐增加。注射后 24 小时,抗原表达与感兴趣区域内的平均放射性活度和吸收剂量率之间的相关性由正相关变为负相关。与未治疗的肿瘤相比,用未标记的 BR96 注射的动物,随着时间的推移,抗原阴性区域也在增加。
结果表明,在初始摄取期间,Lewis Y 表达的存活肿瘤细胞最有效地接受治疗。在肿瘤细胞消除和肉芽组织形成后,放射性活度似乎仍留在这些初始摄取区域。进一步使用这些技术的研究可能有助于确定肿瘤内放射性活度分布对整体治疗效果的影响。