Mitchell J S
Br J Cancer. 1974 May;29(5):373-88. doi: 10.1038/bjc.1974.85.
An attempt has been made to develop tritiated derivatives of Synkavit (menadiol sodium diphosphate, MNDP) of high specific activity as a radioactive drug.This paper summarizes the preliminary biological and physical studies, with emphasis on approximate radiation dosimetry and the necessary preliminary testing, and then gives an account of the clinical investigations and the trials carried out so far, which correspond essentially to Phases I and II trials for a chemotherapeutic agent.In all, 214 patients with different sites and types of advanced and recurrent, inoperable, histologically verified malignant tumours including reticuloses have been treated with doses of at least 1 Ci of the various preparations. Among the 203 evaluable treated cases, some form of response was observed in 23 out of 151 (15·2%) receiving the drug by intravenous injections and 13 out of 52 (25%) after intra-arterial injections. For the sites and types of malignant diseases which showed responses after either intravenous or intra-arterial administration among the 55 patients surviving at least 3 months after the first injection, some form of response was observed in 32 but only 5 of these showed either a "complete" or a "partial" response.It is concluded that further investigation is desirable. It is suggested that clinical trials with randomization should be carried out for inoperable cases of carcinoma of the colon and of the pancreas.
已尝试研发具有高比活度的放射性药物——合成维生素K(甲萘二酚二磷酸酯钠,MNDP)的氚标记衍生物。本文总结了初步的生物学和物理学研究,重点是近似辐射剂量测定法及必要的初步试验,然后阐述了目前所进行的临床研究和试验,这些研究和试验本质上相当于一种化疗药物的Ⅰ期和Ⅱ期试验。总共214例患有不同部位和类型的晚期复发性、无法手术切除且经组织学证实的恶性肿瘤(包括网状细胞增多症)的患者接受了至少1居里各种制剂的治疗。在203例可评估的治疗病例中,151例接受静脉注射该药的患者中有23例(15.2%)出现了某种形式的反应,52例接受动脉内注射的患者中有13例(25%)出现了反应。对于首次注射后至少存活3个月的55例患者中,静脉或动脉内给药后出现反应的恶性疾病的部位和类型,有32例出现了某种形式的反应,但其中只有5例显示出“完全”或“部分”反应。得出的结论是需要进一步研究。建议对无法手术的结肠癌和胰腺癌病例进行随机化临床试验。