Radioimmunotherapy with Monoclonal Antibodies

Marie-Luise Sautter-Bihl; H. Bihl

doi:10.1055/s-0038-1629812

Nuklearmedizin - NuclearMedicine, Table of Contents

Nuklearmedizin 1994; 33(04): 167-173
DOI: 10.1055/s-0038-1629812

Original Article

Schattauer GmbH

Radioimmunotherapy with Monoclonal Antibodies^[*]

A New Horizon in Nuclear Medicine Therapy?

Marie-Luise Sautter-Bihl

¹From the Dept. of Radiooncology and Nuclear Medicine, Klinikum Karlsruhe, and the Dept. of Nuclear Medicine, Katharinenhospital, Stuttgart, FRG

,

H. Bihl

¹From the Dept. of Radiooncology and Nuclear Medicine, Klinikum Karlsruhe, and the Dept. of Nuclear Medicine, Katharinenhospital, Stuttgart, FRG

› Author Affiliations

Abstract

Summary

Radioimmunotherapy (RIT) with labeled tumor-associated monoclonal antibodies (MAbs) is a promising concept in oncology, which essentially consists of biological targeting of ionising radiation to tumors. Some encouraging clinical results have been achieved with RIT. However, there are severe problems associated with both understanding the mechanisms and predicting the effectiveness of RIT. This paper reviews the results of some major clinical trials, especially in malignant lymphomas and in some solid tumors. Furthermore, problems with RIT are described such as the significance of dose inhomogeneity and dose-rate effects, the appropriate dose calculation method, the toxicity of RIT and the development of HAMAs. It is suggested that newer technologies including chimeric antibodies, multiple-step targeting protocols, bone marrow transplantation, parallel application of external radiation, heat or bioreductive drugs will enable RIT to make an essential contribution to strategies for combating cancer.

Zusammenfassung

Die Radioimmuntherapie (RIT) mit radiomarkierten, tumorassoziierten monoklonalen Antikörpern (MAbs) stellt ein vielversprechendes Konzept in der Onkologie dar. Unter Ausnutzung biologischer Mechanismen wird hierbei ionisierende Strahlung gezielt in Tumoren gebracht. Einige ermutigende klinische Ergebnisse wurden bereits erzielt; es existiert jedoch eine Reihe grundsätzlicher Probleme bei der RIT; ihr Wirkmechanismus ist nicht im Detail geklärt und nur in Einzelfällen gelingt eine zuverlässige Voraussage ihrer Effektivität. Die vorliegende Arbeit gibt einen Überblick über klinische Studien bei malignen Lymphomen und einigen soliden Tumoren. Darüber hinaus werden prinzipielle Probleme der RIT im Zusammenhang mit Dosisinhomogenität, Dosisrate, Dosimetrie, Toxizität und potentieller HAMA-Entwicklung analysiert. Neuere Technologien wie chimäre Antikörper, Mehrschnitt-Targeting Verfahren, BMT, kombinierter Einsatz von RIT mit externer Radiatio, Hyperthermie und immunmodulierenden Agentien werden zu einer Weiterentwicklung der RIT im Sinne eines zukünftigen Routineverfahrens der Onkologie beitragen.

Key words

Radioimmunotherapy - monoclonal antibodies - clinical trials - radiobiology

Schlüsselwörter

Radioimmuntherapie - monoklonale Antikörper - klinische Studien - Radiobiologie

Full Text

References

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Radioimmunotherapy with Monoclonal Antibodies[*]

Radioimmunotherapy with Monoclonal Antibodies^[*]