131I Radioconjugated Antibodies for the Locoregional Radioimmunotherapy of High-grade Malignant Glioma: Phase I and II Study

Locoregional radioimmunotherapy (LR-RIT) was administered to 111 patients (20 were recruited in a phase I and 91 in a phase II study) with malignant gliomas: 1 patient with oligodendroglioma, 7 patients with anaplastic oligodendroglioma, 2 with grade II astrocytoma, 10 with anaplastic astrocytoma an...

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Published in:Acta oncologica 1999, Vol.38 (3), p.351-359
Main Author: Pietro Riva, Giancarlo Franceschi, Massimo Frattarelli, Nada Riva, Graziano Guiducci, Anna Maria Cremonini, Graziano Giuliani, Michela Casi, Rossella Gentile, Annti A. Jekunen, Kalevi J. A. Kairemo
Format: Article
Language:English
Subjects:
Adult
Aged
Biological and medical sciences
Dose-Response Relationship, Radiation
Glioblastoma - radiotherapy
Glioma - mortality
Glioma - pathology
Glioma - radiotherapy
Humans
Immunoconjugates
Iodine Radioisotopes
Male
Medical sciences
Middle Aged
Oligodendroglioma - radiotherapy
Other treatments
Quality of Life
Radioimmunotherapy - methods
Survival Rate
Tissue Distribution
Treatment. General aspects
Tumors
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Summary:Locoregional radioimmunotherapy (LR-RIT) was administered to 111 patients (20 were recruited in a phase I and 91 in a phase II study) with malignant gliomas: 1 patient with oligodendroglioma, 7 patients with anaplastic oligodendroglioma, 2 with grade II astrocytoma, 10 with anaplastic astrocytoma and 91 with glioblastoma, amounting to 58 newly diagnosed and 53 recurrent tumours. The 131I-labelled monoclonal antibodies BC-2 and BC-4 were used in order to recognize stromal and intracellular glycoprotein tenascin, an antigen present particularly in glioblastoma. The patients were enrolled between February 1990 and December 1997 after conventional therapy. The radiopharmaceutical was injected directly into the tumour site. Sequential scintigraphies demonstrated a high and enduring uptake in the tumour. The mean irradiation dose in the tumour was 300 Gy per cycle. In the group of 74 phase II glioblastoma patients the clinical responses were as follows: 10 patients with stable disease (SD), 9 with partial responses (PR), 23 with no evidence of disease (NED) and 1 patient with complete response (CR). The median survival was 19 months. The response rate (CR+PR+NED) was 17.8% for those patients with bulky lesions, with a median survival of 17 months, but 66.6% for patients with small lesions, with a median survival of 25 months. Better outcomes were recorded in cases with less aggressive diseases: oligodendroglioma, anaplastic oligodendroglioma and anaplastic astrocytoma. We conclude that fractionated LR-RIT can be safely performed, with promising results especially in patients with minimal disease.
ISSN:0284-186X
1651-226X
DOI:10.1080/028418699431438