title: Radioimmunotherapy of neoplastic meningitis in rats using an alpha-particle-emitting immunoconjugate.
abstract: Because of their short range and high linear energy transfer, alpha-particles may be particularly effective in the treatment of neoplastic meningitis. Monoclonal antibody 81C6 was labeled with alpha-particle-emitting 211At using N-succinimidyl3-[211At]astatobenzoate, and the efficacy and toxicity of this immunoconjugate were evaluated in an athymic rat model. Animals were given injections via a chronic indwelling catheter with 5 x 10(5) TE-671 human rhabdomyosarcoma cells and treated 8 days later with single intrathecal doses of either saline or 4-18 microCi of 211At-labeled specific 81C6 antibody or isotype-matched control 211At-labeled 45.6 antibody. In the first experiment, 4, 7, and 13 microCi 211At-labeled 81C6 produced statistically significant (P = 0.004-0.02) increases in median survival of 33, 29, and 51%, respectively, as compared with saline. Two of 10 animals receiving the 13-microCi dose lived for 6 months before being killed for histological analysis. In the second experiment, 12 microCi of 211At-labeled 45.6 did not increase median survival significantly relative to saline control, while 12 microCi of 211At-labeled 81C6 increased median survival by 113% (P < 0.005) and resulted in 33% apparent cures. Five of 10 animals receiving 18 microCi of 211At-labeled 81C6 survived until they were killed at 295 days. An additional study was performed in animals given intrathecal injections of 5 x 10(6) TE-671 cells and given a single dose of 18 microCi of 211At-labeled 81C6 or 211At-labeled 45.6. At this higher cell number, significantly prolonged survival was still seen for specific antibody as compared with saline (P < 0.001) and control antibody (P < 0.05). These results suggest that treatment with 211At-labeled monoclonal antibodies may be a valuable approach for neoplastic meningitis.
authors.affiliation: Department of Radiology, Duke University Medical Center, Durham, North Carolina 27710.
authors.forename: M R
authors.initials: MR
authors.lastname: Zalutsky
authors.forename: R E
authors.initials: RE
authors.lastname: McLendon
authors.forename: P K
authors.initials: PK
authors.lastname: Garg
authors.forename: G E
authors.initials: GE
authors.lastname: Archer
authors.forename: J M
authors.initials: JM
authors.lastname: Schuster
authors.forename: D D
authors.initials: DD
authors.lastname: Bigner
mesh_terms: D000512:Alpha Particles / Q000627:therapeutic use*; D000818:Animals; D000911:Antibodies, Monoclonal / Q000378:metabolism / Q000627:therapeutic use*; D001246:Astatine / Q000493:pharmacokinetics / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008577:Meningeal Neoplasms / Q000532:radiotherapy*; D008581:Meningitis / Q000209:etiology / Q000532:radiotherapy*; D016499:Radioimmunotherapy / Q000379:methods*; D051381:Rats; D011923:Rats, Nude; D012208:Rhabdomyosarcoma / Q000532:radiotherapy*
chemical_list: D000911:Antibodies, Monoclonal; D001246:Astatine