title: Use of monoclonal anti-EGFR antibody in the radioimmunotherapy of malignant gliomas in the context of EGFR expression in grade III and IV tumors.
abstract: We investigated the putative benefits of simultaneous teleradiotherapy and anti-epidermal growth factor receptor (EGFR) 125I monoclonal antibody (MAb) 425 radioimmunotherapy, when applied after neurosurgery in high-grade gliomas, over teleradiotherapy alone. In comparison to previous studies which have reported good results with this type of radioimmunotherapy, we advanced the adjuvant radioimmunotherapy step, that is, gave it during, not after, teleradiotherapy. The randomized prospective study examined two groups: simultaneous postoperative teleradiotherapy and radioimmunotherapy (TRT + RIT; eight patients) versus teleradiotherapy alone (TRT; 10 patients). Patients who after primary operation of grade III (6 cases) or IV glioma (12 cases), showed no or less than 2 mL of remnant tumor on post-operative magnetic resonance (MR) study and were not treated postoperatively by chemotherapy were enrolled and randomized. Anti-EGFR 125IMAb 425 RIT was started during week 4 of radiotherapy, not later than 8 weeks after neurosurgery, and was repeated three times at 1-week intervals. Total activity given was 5026 + 739 MBq/patient. The tolerance of TRT was good. No immediate side effects of concomitant anti-EGRF 125I RIT were observed. Observation showed a median total survival (as evaluated from the primary neurosurgical treatment) of 14 months (range 3.5-28 months). There was no improvement in disease-free or total survival in the group of patients treated by TRT + RIT after neurosurgery. In addition, an immunohistochemical analysis of EGFR expression in gliomas was performed in a group of 100 cases and was distinctly positive in 50% grade IV gliomas and 68% grade III gliomas. We conclude that simultaneous radiotherapy and radioimmunotherapy with anti-EGFR 125I-MAb 425 is not beneficial over radiotherapy alone in adjuvant treatment of high-grade gliomas after neurosurgery. We also recommend individual confirmation of EGFR expression in further anti-EGFR radioimmunotherapy trials.
authors.affiliation: Department of Nuclear Medicine and Endocrine Oncology, Maria Skłodowska-Curie Memorial Institute and Center of Oncology, Gliwice, Poland.
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Wygoda
authors.forename: Dorota
authors.initials: D
authors.lastname: Kula
authors.forename: Grazyna
authors.initials: G
authors.lastname: Bierzyńska-Macyszyn
authors.forename: Dawid
authors.initials: D
authors.lastname: Larysz
authors.forename: Michał
authors.initials: M
authors.lastname: Jarzab
authors.forename: Paweł
authors.initials: P
authors.lastname: Właszczuk
authors.forename: Piotr
authors.initials: P
authors.lastname: Bazowski
authors.forename: Maciej
authors.initials: M
authors.lastname: Wojtacha
authors.forename: Adam
authors.initials: A
authors.lastname: Rudnik
authors.forename: Tomasz
authors.initials: T
authors.lastname: Stepień
authors.forename: Wojciech
authors.initials: W
authors.lastname: Kaspera
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Etmańska
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Składowski
authors.forename: Rafał
authors.initials: R
authors.lastname: Tarnawski
authors.forename: Danuta
authors.initials: D
authors.lastname: Kokocińska
authors.forename: Barbara
authors.initials: B
authors.lastname: Jarzab
mesh_terms: D000328:Adult; D000818:Animals; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D066246:ErbB Receptors / Q000096:biosynthesis / Q000235:genetics / Q000276:immunology*; D005260:Female; D005910:Glioma / Q000276:immunology* / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D008297:Male; D051379:Mice; D008807:Mice, Inbred BALB C; D008875:Middle Aged; D009367:Neoplasm Staging; D016499:Radioimmunotherapy; D012720:Severity of Illness Index; D000090324:Tumor Protein, Translationally-Controlled 1
chemical_list: D000911:Antibodies, Monoclonal; D007457:Iodine Radioisotopes; C000715648:Tpt1 protein, mouse; D000090324:Tumor Protein, Translationally-Controlled 1; D066246:ErbB Receptors