title: Long term response in a patient with neoplastic meningitis secondary to melanoma treated with (131)I-radiolabeled antichondroitin proteoglycan sulfate Mel-14 F(ab')(2): a case study.
abstract: Even with novel chemotherapeutic agents and external beam radiation therapy, the prognosis of neoplastic meningitis secondary to malignant melanoma is still dismal. The authors report a case study of a 46-year-old white female who presented with progressive hearing loss, severe headaches, nausea, vomiting, and a rapid decline in neurologic status. She was referred to Duke University Medical Center after conventional chemotherapy for malignant melanoma failed. She was enrolled in a Phase I trial of (131)I-labeled monoclonal antibody Mel-14 F(ab')(2) fragment administered intrathecally. Within a year after her treatment, she recovered, having a normal neurologic exam except for residual bilateral hearing loss. The authors discuss dosimetry, preclinical, and clinical studies conducted with Mel-14 F(ab')(2) and introduce a potentially promising therapy option in the treatment of neoplastic meningitis in patients with malignant melanoma. Currently, the patient remains neurologically normal except for a mild bilateral hearing loss more than 4 years after treatment and has no radiographic evidence of neoplastic meningitis.
authors.affiliation: Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: I
authors.initials: I
authors.lastname: Cokgor
authors.forename: G
authors.initials: G
authors.lastname: Akabani
authors.forename: H S
authors.initials: HS
authors.lastname: Friedman
authors.forename: A H
authors.initials: AH
authors.lastname: Friedman
authors.forename: M R
authors.initials: MR
authors.lastname: Zalutsky
authors.forename: L M
authors.initials: LM
authors.lastname: Zehngebot
authors.forename: J M
authors.initials: JM
authors.lastname: Provenzale
authors.forename: C D
authors.initials: CD
authors.lastname: Guy
authors.forename: C J
authors.initials: CJ
authors.lastname: Wikstrand
authors.forename: D D
authors.initials: DD
authors.lastname: Bigner
mesh_terms: D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D002809:Chondroitin Sulfates / Q000276:immunology; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000009:adverse effects / Q000627:therapeutic use*; D019041:L-Selectin / Q000276:immunology; D008545:Melanoma / Q000532:radiotherapy*; D008581:Meningitis / Q000209:etiology*; D008875:Middle Aged; D019275:Radiopharmaceuticals / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D000911:Antibodies, Monoclonal; D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals; D019041:L-Selectin; D002809:Chondroitin Sulfates