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Dosimetry and radiographic analysis of 131I-labeled anti-tenascin 81C6 murine monoclonal antibody in newly diagnosed patients with malignant gliomas: a phase II study.

Publication ,  Journal Article
Akabani, G; Reardon, DA; Coleman, RE; Wong, TZ; Metzler, SD; Bowsher, JE; Barboriak, DP; Provenzale, JM; Greer, KL; DeLong, D; Friedman, HS ...
Published in: J Nucl Med
June 2005

UNLABELLED: The objective was to perform dosimetry and evaluate dose-response relationships in newly diagnosed patients with malignant brain tumors treated with direct injections of (131)I-labeled anti-tenascin murine 81C6 monoclonal antibody (mAb) into surgically created resection cavities (SCRCs) followed by conventional external-beam radiotherapy and chemotherapy. METHODS: Absorbed doses to the 2-cm-thick shell, measured from the margins of the resection cavity interface, were estimated for 33 patients with primary brain tumors. MRI/SPECT registrations were used to assess the distribution of the radiolabeled mAb in brain parenchyma. Results from biopsies obtained from 15 patients were classified as tumor, radionecrosis, or tumor and radionecrosis, and these were correlated with absorbed dose and dose rate. Also, MRI/PET registrations were used to assess radiographic progression among patients. RESULTS: This therapeutic strategy yielded a median survival of 86 and 79 wk for all patients and glioblastoma multiforme (GBM) patients, respectively. The average SCRC residence time of (131)I-mu81C6 mAb was 76 h (range, 34-169 h). The average absorbed dose to the 2-cm cavity margins was 48 Gy (range, 25-116 Gy) for all patients and 51 Gy (range, 27-116 Gy) for GBM patients. In MRI/SPECT registrations, we observed a preferential distribution of (131)I-mu81C6 mAb through regions of vasogenic edema. An analysis of the relationship between the absorbed dose and dose rate and the first biopsy results yielded a most favorable absorbed dose of 44 Gy. A correlation between decreased survival and irreversible neurotoxicity was noted. A comparative analysis, in terms of median survival, was performed with previous brachytherapy clinical studies, which showed a proportional relationship between the average boost absorbed dose and the median survival. CONCLUSION: This study shows that (131)I-mu81C6 mAb increases the median survival of GBM patients. An optimal absorbed dose of 44 Gy to the 2-cm cavity margins is suggested to reduce the incidence of neurologic toxicity. Further clinical studies are warranted to determine the effectiveness of (131)I-mu81C6 mAb based on a target dose of 44 Gy rather than a fixed administered activity.

Duke Scholars

Published In

J Nucl Med

ISSN

0161-5505

Publication Date

June 2005

Volume

46

Issue

6

Start / End Page

1042 / 1051

Location

United States

Related Subject Headings

  • Tenascin
  • Reoperation
  • Radiometry
  • Radioimmunotherapy
  • Positron-Emission Tomography
  • Nuclear Medicine & Medical Imaging
  • Neoplasm Recurrence, Local
  • Middle Aged
  • Mice
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Akabani, G., Reardon, D. A., Coleman, R. E., Wong, T. Z., Metzler, S. D., Bowsher, J. E., … Zalutsky, M. R. (2005). Dosimetry and radiographic analysis of 131I-labeled anti-tenascin 81C6 murine monoclonal antibody in newly diagnosed patients with malignant gliomas: a phase II study. J Nucl Med, 46(6), 1042–1051.
Akabani, Gamal, David A. Reardon, R Edward Coleman, Terence Z. Wong, Scott D. Metzler, James E. Bowsher, Daniel P. Barboriak, et al. “Dosimetry and radiographic analysis of 131I-labeled anti-tenascin 81C6 murine monoclonal antibody in newly diagnosed patients with malignant gliomas: a phase II study.J Nucl Med 46, no. 6 (June 2005): 1042–51.
Akabani G, Reardon DA, Coleman RE, Wong TZ, Metzler SD, Bowsher JE, et al. Dosimetry and radiographic analysis of 131I-labeled anti-tenascin 81C6 murine monoclonal antibody in newly diagnosed patients with malignant gliomas: a phase II study. J Nucl Med. 2005 Jun;46(6):1042–51.
Akabani G, Reardon DA, Coleman RE, Wong TZ, Metzler SD, Bowsher JE, Barboriak DP, Provenzale JM, Greer KL, DeLong D, Friedman HS, Friedman AH, Zhao X-G, Pegram CN, McLendon RE, Bigner DD, Zalutsky MR. Dosimetry and radiographic analysis of 131I-labeled anti-tenascin 81C6 murine monoclonal antibody in newly diagnosed patients with malignant gliomas: a phase II study. J Nucl Med. 2005 Jun;46(6):1042–1051.

Published In

J Nucl Med

ISSN

0161-5505

Publication Date

June 2005

Volume

46

Issue

6

Start / End Page

1042 / 1051

Location

United States

Related Subject Headings

  • Tenascin
  • Reoperation
  • Radiometry
  • Radioimmunotherapy
  • Positron-Emission Tomography
  • Nuclear Medicine & Medical Imaging
  • Neoplasm Recurrence, Local
  • Middle Aged
  • Mice
  • Male