astatine and Lymphoma

Radionuclides which decay by the emission of alpha-particles are attractive for certain radioimmunotherapeutic applications. These include the treatment of lymphomas, compartmentally spread malignancies such as ovarian cancer and neoplastic meningitis, and micrometastatic disease. Two alpha-emitting radionuclides of interest for this purpose are 212Bi (60.6 min half life) and 211At (7.2 hr half life). Compared with the beta-emitters commonly used for radiotherapy, the alpha-particles of 212Bi and 211At are of higher energy, much shorter range (less than 100 microm), and considerably higher linear energy transfer. Preliminary results obtained in a variety of in vitro systems and in vivo models have documented the exquisite toxicity of alpha-particles and have established a basis for initiating radiotherapy trials in humans with monoclonal antibodies labeled with alpha-emitting radionuclides.

Topics: Alpha Particles; Antibodies, Monoclonal; Astatine; Bismuth; Female; Half-Life; Humans; Immunoconjugates; Linear Energy Transfer; Lymphoma; Meningitis; Neoplasm Metastasis; Ovarian Neoplasms; Radioimmunotherapy; Radioisotopes

6-[211At]-astato-MNDP is a high-LET endoradiotherapeutic drug that selectively targets to an oncogenically associated alkaline phosphatase isoenzyme expressed by certain tumors. A detailed histopathological study of the late tissue effects of its endogenous alpha-particle emissions has been carried out in a murine tumor model.. Thyroid-blocked male C57BI/10 mice bearing a s.c. transplanted rectal adenocarcinoma were treated with a single i.p. injection of 10-750 kBq 6-[211At]-astato-MNDP. Cured mice (131) were studied. Detailed autopsies and histological examinations were performed on all mice. The study was concluded after 756 days.. Lymphoma, plasmacytoma, and intercurrent infections secondary to chronic pulmonary fibrosis were the most commonly found late manifestations of alpha-radiation exposure. Low grade B-cell non-Hodgkin's lymphoma occurred in 19 (24.7%) of 77 mice, 13-17 months after receiving 3.5-185 kBq 6-[211At]-astato-MNDP. The incidence of lymphoma alone and its latency was similar to that of the control population (23.3%). Treatment doses exceeding 200 kBq 6-[211At]-astato-MNDP, were associated with the development of soft tissue plasmacytoma in 7 (13%) of 54 mice, after 17-22 months. Generalized debilitation and nonspecific infections supervening pulmonary fibrosis significantly contributed to the late morbidity and mortality observed in mice treated with 300-750 kBq 6-[211At]-astato-MNDP. Dosimetry has afforded LD50/360 and LD50/420 estimates of 12-14 and 10-12 Cobalt-Gray equivalent (CGyE), respectively, for chronic lung damage. There was no histological evidence of chronic radiation damage to other critical healthy tissues. Normal thyroid morphology was preserved.. Dose activities of 6-[211At]-astato-MNDP exceeding 300 kBq, were associated an increased risk of tumor induction and development of varying degrees of chronic pulmonary fibrosis implicated in the onset of terminal intercurrent infections. Within the therapeutic dose range 55-300 kBq 6-[211At]-astato-MNDP, mortality associated with the incidence of significant late radiation damage in critical normal tissues and latent carcinogenesis was less than 15%. Data from this murine model suggest that clinically relevant activities of 6-[211At]-astato-MNDP may be given without unacceptable toxicity.

Topics: Animals; Astatine; Dose-Response Relationship, Radiation; Drug Screening Assays, Antitumor; Lung; Lymphoma; Male; Mice; Mice, Inbred C57BL; Plasmacytoma; Radiation Injuries, Experimental; Radiopharmaceuticals; Thyroid Gland

The short-lived isotope 211At (half-life, 7.2 hr), an alpha particle-emitting halogen, has been attached to a monoclonal antibody (anti-thy 1.1, IgG1, OX7) and used in mice in the treatment of a thy 1.1 T-cell lymphoma (A120). Forty-eight hours after receiving an iv injection of 10(3) or 10(5) A120 cells, mice were treated with phosphate-buffered saline, 211At-, antibody alone, or 211At conjugated to OX7. Treatment with the 211At-labeled OX7 conjugate increased the median survival time of mice and probably "cured" (survival at 200 days) 6 of the 15 mice given 10(5) cells and 21 of the 27 mice given 10(3) cells.

Topics: Animals; Antibodies, Monoclonal; Astatine; Female; Isoantibodies; Lymphoma; Mice; T-Lymphocytes