Juweid M, Sharkey R M, Alavi A, Swayne L C, Herskovic T, Hanley D, Rubin A D, Pereira M, Goldenberg D M
Garden State Cancer Center, Center for Molecular Medicine and Immunology, Belleville, New Jersey 07109-0023, USA.
J Nucl Med. 1997 Feb;38(2):257-60.
Advanced chemotherapy-resistant ovarian cancer has a poor prognosis, thus requiring new therapeutic modalities. A complete clinical remission, using two cycles of 131I-labeled murine MN-14 anti-CEA monoclonal antibody (MAb), given intravenously, is reported in a patient with advanced ovarian cancer refractory to paclitaxel (Taxol) therapy. The patient first received radioimmunotherapy with approximately 74 mCi 131I-MN-14 IgG, followed 4 mo later by a similar dose of radiolabeled MAb. A partial remission was seen by CT 1 mo after the first radioimmunotherapy, and a further objective response was documented after the second radioimmunotherapy. CT scans performed 6 and 11 mo after the second radioimmunotherapy showed stable and minimal residual changes. However, a whole-body PET scan with [18F]fluorodeoxyglucose (FDG-PET) was negative in these regions. The CA-125 also decreased to only 13 U/ml, compared to the baseline value of 7700 U/ml. Based on CT, FDG-PET, serum CA-125 and physical exam, the patient was in complete clinical remission for 8 mo when the CA-125 levels rose. CT also showed a new suspicious lesion, presumably a peritoneal implant. No toxicity was seen after the first injection, and only Grade 1 thrombocytopenia and Grade 2 leukopenia developed after the second injection, both reversing within 6 wk. This is a report of a complete clinical remission with radiolabeled anti-CEA antibodies in a patient with chemotherapy-refractive metastatic ovarian cancer.
晚期化疗耐药性卵巢癌预后较差，因此需要新的治疗方式。据报道，一名对紫杉醇（泰素）治疗无效的晚期卵巢癌患者，静脉注射两个疗程的131I标记的鼠抗CEA单克隆抗体（MAb）后实现了完全临床缓解。该患者首先接受了约74毫居里131I-MN-14 IgG的放射免疫治疗，4个月后又接受了相同剂量的放射性标记单克隆抗体治疗。首次放射免疫治疗1个月后CT显示部分缓解，第二次放射免疫治疗后记录到进一步的客观反应。第二次放射免疫治疗后6个月和11个月进行的CT扫描显示病变稳定且残留变化极小。然而，这些区域的[18F]氟脱氧葡萄糖全身PET扫描（FDG-PET）呈阴性。与基线值7700 U/ml相比，CA-125也降至仅13 U/ml。根据CT、FDG-PET、血清CA-125和体格检查，该患者临床完全缓解8个月，之后CA-125水平上升。CT还显示一个新的可疑病变，可能是腹膜种植转移灶。首次注射后未观察到毒性反应，第二次注射后仅出现1级血小板减少和2级白细胞减少，均在6周内恢复。本文报道了一名化疗难治性转移性卵巢癌患者接受放射性标记抗CEA抗体治疗后实现完全临床缓解的病例。
