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Targeted radioimmunotherapy for leptomeningeal cancer using (131)I-3F8
K Kramer1, N K Cheung, J L Humm
1Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA. kramerk@mskcc.org
Background:
Intrathecal antibody-based targeted therapies may have clinical potential for patients with leptomeningeal (LM) cancer.
Procedure:
Five patients with GD2-positive LM tumors were injected with 1-2 mCi intra-Ommaya (131)I-3F8, a murine IgG3 antibody specific for GD2. Serial cerebrospinal fluid (CSF) and serum samples and SPECT imagings (4, 24, and 48 hr) were performed to predict radiation doses to the tumor and normal brain and blood prior to the administration of larger therapeutic doses.
Results:
Side effects included self-limited fever, headache, and vomiting. Focal (131)I-3F8 uptake consistent with tumors was seen along the craniospinal axis in four patients. Calculated radiation dose to the CSF was 14.9-56 cGy/mCi and to blood and other organs outside the CNS less than 2 cGy/mCi.
Conclusions:
Intraventricular (131)I-3F8 successfully detected LM disease and resulted in a large favorable CSF/blood ratio. Intraventricular (131)I-3F8 may have clinical utility in the diagnosis and radioimmunotherapy of GD2-positive LM cancers. Med. Pediatr. Oncol. 35:716-718. 2000.