Radioimmunoguided surgery using monoclonal antibody.
The potential proficiency of radioimmunoguided surgery in the intraoperative detection of tumors was assessed using labeled monoclonal antibody B72.3 in 66 patients with tissue-proved tumor. Monoclonal antibody B72.3 was injected 5 to 42 days preoperatively, and the hand-held gamma-detecting probe was used intraoperatively to detect the presence of tumor. Intraoperative probe counts of less than 20 every 2 seconds, or tumor-to-adjacent normal tissue ratios less than 2:1 were considered negative (system failure). Positive probe counts were detected in 5 of 6 patients with primary colon cancer (83 percent), in 31 of 39 patients with recurrent colon cancer (79 percent), in 4 of 5 patients with gastric cancer (80 percent), in 3 of 8 patients with breast cancer (37.5 percent), and in 4 of 8 patients with ovarian cancer (50 percent) undergoing second-look procedures. Additional patients in each group were scored as borderline positive. Overall, radioimmunoguided surgery using B72.3 identified tumors in 47 patients (71.2 percent), bordered on positive in 6 patients (9.1 percent), and failed to identify tumor in 13 patients (19.7 percent). Improved selection of patients for antigen-positive tumors, the use of higher affinity second-generation antibodies, alternate routes of antibody administration, alternate radionuclides, and more sophisticatedly bioengineered antibodies and antibody combinations should all lead to improvements in radioimmunoguided surgery.
Martin
E W
EW
Department of Surgery, Ohio State University College of Medicine, Columbus.
Mojzisik
C M
CM
Hinkle
G H
GH
Sampsel
J
J
Siddiqi
M A
MA
Tuttle
S E
SE
Sickle-Santanello
B
B
Colcher
D
D
Thurston
M O
MO
Bell
J G
JG
D000911:Antibodies, Monoclonal; D001943:Breast Neoplasms / Q000175:diagnosis / Q000601:surgery*; D003110:Colonic Neoplasms / Q000175:diagnosis / Q000601:surgery*; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D007457:Iodine Radioisotopes; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000601:surgery*; D012588:Scintillation Counting; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000601:surgery*
D000911:Antibodies, Monoclonal; D007457:Iodine Radioisotopes