Department of Molecular Imaging and Therapy, Beckman Research Institute, City of Hope, Duarte, California.
Irell and Manella Graduate School of Biological Sciences, Beckman Research Institute, City of Hope, Duarte, California.
J Nucl Med. 2021 Jan;62(1):55-61. doi: 10.2967/jnumed.120.243394. Epub 2020 Jul 3.
Radioimmunotherapy, an approach using radiolabeled antibodies, has had minimal success in the clinic with several β-emitting radionuclides for the treatment of ovarian cancer. Alternatively, radioimmunotherapy with α-emitters offers the advantage of depositing much higher energy over shorter distances but was thought to be inappropriate for the treatment of solid tumors, for which antibody penetration is limited to a few cell diameters around the vascular system. However, the deposition of high-energy α-emitters to tumor markers adjacent to a typical leaky tumor vascular system may have large antitumor effects at the tumor vascular level, and their reduced penetration in normal tissue would be expected to lower off-target toxicity. To evaluate this concept, DOTAylated-huCC49 was labeled with the α-emitter Ac to target tumor-associated glycoprotein 72-positive xenografts in a murine model of ovarian cancer. Ac-labeled DOTAylated-huCC49 radioimmunotherapy significantly reduced tumor growth in a dose-dependent manner (1.85, 3.7, and 7.4 kBq), with the 7.4-kBq dose extending survival by more than 3-fold compared with the untreated control. Additionally, a multitreatment regime (1.85 kBq followed by 5 weekly doses of 0.70 kBq for a total of 5.4 kBq) extended survival almost 3-fold compared with the untreated control group, without significant off-target toxicity. These results establish the potential for antibody-targeted α-radionuclide therapy for ovarian cancer, which may be generalized to α-radioimmunotherapy in other solid tumors.
放射免疫治疗是一种使用放射性标记抗体的方法,在使用几种β发射放射性核素治疗卵巢癌的临床应用中收效甚微。相比之下,使用α发射体的放射免疫治疗具有在更短距离内沉积更高能量的优势,但被认为不适合治疗实体瘤,因为抗体渗透仅限于血管系统周围的几个细胞直径。然而,将高能α发射体沉积到紧邻典型渗漏性肿瘤血管系统的肿瘤标志物上,可能会在肿瘤血管水平上产生巨大的抗肿瘤作用,并且其在正常组织中的穿透减少预计会降低脱靶毒性。为了评估这一概念,用α发射器 Ac 标记 DOTA 化 huCC49,以靶向卵巢癌小鼠模型中肿瘤相关糖蛋白 72 阳性异种移植物。Ac 标记的 DOTA 化 huCC49 放射免疫治疗以剂量依赖性方式显著抑制肿瘤生长(1.85、3.7 和 7.4 kBq),7.4 kBq 剂量与未治疗对照组相比,使生存期延长了 3 倍以上。此外,多治疗方案(1.85 kBq 后再给予 5 周 0.70 kBq 的剂量,总剂量为 5.4 kBq)与未治疗对照组相比,使生存期延长了近 3 倍,而无明显的脱靶毒性。这些结果确立了针对卵巢癌的抗体靶向α放射性核素治疗的潜力,这可能推广到其他实体瘤的α放射免疫治疗。