[Systemic radiotherapy using monoclonal antibodies. Options and problems].

Radiolabeled monoclonal antibodies (MAbs), by virtue of their tumor specificity, offer the prospect of localized, highly targeted radiation treatment of malignant tumors. To date, a large number of radioimmunotherapy (RIT) studies have been reported in experimental and clinical settings showing the potential of this therapeutic strategy. This includes RIT-trials in hepatoma, cholangiocarcinoma, ovarian carcinoma, brain tumors, melanoma, neuroblastoma and especially Hodgkin's and non-Hodgkin's lymphomas. Despite very promising results in some of these studies, radioimmunotherapy is currently still in a developmental status. Selective accumulation of MAbs at tumor sites-a prerequisite for effective radioimmunotherapy-is a complex process. Many factors such as antigen heterogeneity, distinct antibody features (affinity, subclass, fragment size, etc.), labeling techniques, tumor physiology and competing antigens were identified in the last years using theoretical and experimental tumor models. Strategies to improve these critical parameters are currently under investigation in order to increase the efficacy of radioimmunotherapy.