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Current status of radioimmunotherapy
S M Larson1, C R Divgi, A Scott
1Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
Nuclear Medicine and Biology
|July 1, 1994
Summary
Radioimmunotherapy shows promise for hematopoietic tumors but faces challenges with solid tumors. Further research is needed to improve therapeutic indices for solid tumor treatment.
Area of Science:
- Oncology
- Nuclear Medicine
- Immunology
Background:
- Radioimmunotherapy (RIT) using radiolabeled monoclonal antibodies is effective for hematopoietic malignancies.
- RIT for solid tumors has yielded limited and non-persistent responses.
- Hematopoietic toxicity, particularly affecting platelets, is the primary dose-limiting toxicity.
Purpose of the Study:
- To evaluate the effectiveness and limitations of radioimmunotherapy for various tumor types.
- To discuss the challenges and potential improvements in RIT for solid tumors.
- To highlight advancements in dosimetry for RIT dose planning.
Main Methods:
- Utilizing quantitative SPECT and PET imaging for improved dosimetry.
- Administering ultra-high doses of 131I (up to 28 mCi/kg).
- Assessing therapeutic indices, focusing on tumor to marrow ratios.
Main Results:
- Persistent major responses observed in hematopoietic tumors.
- Occasional, non-persistent responses reported for solid tumors.
- Therapeutic indices for tumor/marrow are currently 5-10:1, which is insufficient for curative solid tumor treatment.
Conclusions:
- RIT is a viable treatment for hematopoietic tumors.
- Significant improvements in antibody formulations and delivery are required for effective solid tumor RIT.
- Enhanced dosimetry through advanced imaging is crucial for optimizing RIT strategies.