title: Effective treatment of established human breast tumor xenografts in immunodeficient mice with a single dose of the alpha-emitting radioisotope astatine-211 conjugated to anti-HER2/neu diabodies.
abstract: OBJECTIVE
  Successful radioimmunotherapy strategies depend on selecting radioisotopes with physical properties complementary to the biological properties of the targeting vehicle. Small, engineered antitumor antibody fragments are capable of rapid, highly specific tumor targeting in immunodeficient mouse models. We hypothesized that the C6.5 diabody, a noncovalent anti-HER2 single-chain Fv dimer, would be an ideal radioisotope carrier for the radioimmunotherapy of established tumors using the short-lived alpha-emitting radioisotope (211)At.
  
  
  METHODS
  Immunodeficient nude mice bearing established HER2/neu-positive MDA-MB-361/DYT2 tumors treated with N-succinimidyl N-(4-[(211)At]astatophenethyl)succinamate ((211)At-SAPS)-C6.5 diabody. Additional cohorts of mice were treated with (211)At-SAPS T84.66 diabody targeting the carcinoembryonic antigen or (211)At-SAPS on a diabody specific for the Müllerian inhibiting substance type II receptor, which is minimally expressed on this tumor cell line.
  
  
  RESULTS
  A single i.v. injection of (211)At-SAPS C6.5 diabody led to a 30-day delay in tumor growth when a 20 muCi dose was administered and a 57-day delay in tumor growth (60% tumor-free after 1 year) when a 45 muCi dose was used. Treatment of mice bearing the same tumors with (211)At-SAPS T84.66 diabody at the same doses led to a delay in tumor growth, but no complete responses, likely due to substantially lower expression of this antigen on the MDA-MB-361/DYT2 tumors. In contrast, a dose of 20 muCi of (211)At-SAPS on the anti-Müllerian-inhibiting substance type II receptor diabody did not affect tumor growth rate, demonstrating specificity of the therapeutic effect.
  
  
  CONCLUSIONS
  These findings indicate that diabody molecules can be effective agents for targeted radioimmunotherapy of solid tumors using powerful, short-lived alpha-emitting radioisotopes.
authors.affiliation: Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania 19111, USA.
authors.forename: Matthew K
authors.initials: MK
authors.lastname: Robinson
authors.forename: Calvin
authors.initials: C
authors.lastname: Shaller
authors.forename: Kayhan
authors.initials: K
authors.lastname: Garmestani
authors.forename: Paul S
authors.initials: PS
authors.lastname: Plascjak
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Hodge
authors.forename: Qing-An
authors.initials: QA
authors.lastname: Yuan
authors.forename: James D
authors.initials: JD
authors.lastname: Marks
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Waldmann
authors.forename: Martin W
authors.initials: MW
authors.lastname: Brechbiel
authors.forename: Gregory P
authors.initials: GP
authors.lastname: Adams
mesh_terms: D000818:Animals; D001246:Astatine / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008297:Male; D051379:Mice; D008807:Mice, Inbred BALB C; D008813:Mice, Inbred ICR; D008819:Mice, Nude; D016513:Mice, SCID; D010446:Peptide Fragments; D016499:Radioimmunotherapy; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000276:immunology; D014018:Tissue Distribution; D014183:Transplantation, Heterologous
chemical_list: D001246:Astatine; D010446:Peptide Fragments; D018719:Erb-b2 Receptor Tyrosine Kinases; C524056:Erbb2 protein, mouse