[show abstract][hide abstract] ABSTRACT: 131I-labelled H17E2 monoclonal antibody (MAb) was administered to 16 patients with germ cell tumours of the testis (GCT). Eleven patients had non-seminomatous GCT and five seminoma. The MAb was administered into the webs between the second and third toes of both feet in 12 patients and intravenously in four patients at a dose of 1.5-2mCi. 131I-labelled 2-118 MAb (non-specific) was administered subcutaneously into the webs between the second and third toes of both feet in two patients and intravenously in one patient with non-seminomatous GCT. All three patients had only computed tomography (CT) scan. Patients were scanned immediately after until 7 days post-injection. For comparison all patients had CT scan and eight out of 16 patients had conventional lymphangiography (LG). When the radiolabelled MAb was given subcutaneously, the immunoscan (IS) was true positive in 9/12 (75%) patients and true negative in 2/12 (16.5%) and equivocal in 1/12 (8.5%). The LG gave true positive results in 6/8 (75%) patients and true negative results in 2/8 (25%) and the CT scan true positive results in 8/12 (66.6%) patients, true negative results in 2/12 (16.3%) and false negative results in 2/12 (16.3%). There was an excellent correlation of IS images with the LG results (true positivity 100%). When the radiolabelled MAb was given intravenously, both IS and CT scan gave true positive results in four cases. Our findings showed that the true positivity of IS reached 93.8%, whereas that of CT scan 87.5%. In all three patients who had the 131I-labelled 2-118 non-specific MAb, the IS was false negative, whereas the CT scan was true positive. Thus, this procedure may offer information complementary to that provided by existing conventional imaging methods.
The British journal of cancer. Supplement 08/1990; 10:74-7.
[show abstract][hide abstract] ABSTRACT: HMFG1 tumour associated monoclonal antibody IgG1 and F(ab')2 fragments were radiolabelled with indium-111 and used to study patients with breast cancer. In vitro and in vivo stability of the radiolabelled antibodies was shown to be satisfactory. Thirty patients with primary breast cancer underwent tumour resection and quantitative evaluation of the radioactivity in the tumour and normal tissues following administration of specific and non-specific antibodies. The mean tumour uptake of HMFG1 F(ab')2 fragments at 24 h was significantly higher (P less than 0.05) than the intact IgG but at 48 h there was no difference. The mean tumour uptake with the specific antibody was higher than the non-specific antibody of the same subclass (P less than 0.05). Lymph node metastases showed higher antibody uptake than the corresponding primary tumours (P less than 0.05). Fifteen patients with primary or metastatic breast cancer were investigated by external body scintigraphy using HMFG1 F(ab')2 fragments. Successful localisation was observed in approximately 50% of the primary and metastatic lesions with no false positive results. All the patients had observable concentration of 111In in the liver (20% of the injected dose), the kidneys and the spleen. Following i.v. administration, F(ab')2 fragments cleared from the blood more rapidly than the intact IgG. We conclude that HMFG1 F(ab')2 fragments can localise specifically and faster than intact IgG in breast cancer but the sensitivity of the radioimmunoscintigraphy is relatively low. This method needs further improvement before becoming clinically useful for detecting and staging breast cancer.
British Journal of Cancer 07/1989; 59(6):939-42. · 5.08 Impact Factor
[show abstract][hide abstract] ABSTRACT: Six patients with metastatic breast cancer and malignant pleural effusions and 13 patients with known or suspected ovarian cancer, underwent immunoscintigraphy after intracavitary (intrapleural or intraperitoneal) administration of iodine-131-(131I) or indium-111-(111In) labeled tumor associated monoclonal antibodies HMFG2 and H17E2. This method proved to be sensitive and specific with a true-positive result in 13 out of 14 patients with tumor and a true-negative result in five out of five patients without tumor. At any one time, 65%-80% of the whole-body radioactivity was closely associated with the cavity into which the radiolabeled antibody was administered while the radioactivity in the blood was always low, (approximately 4 X 10(-3) of administered dose/ml of blood). Concentrations of radiolabeled antibody (per gram of tumor tissue) ranged from 0.02%-0.1% of the injected dose in intracavitary tumors, but only 0.002% in a retroperitoneal metastasis. The specificity of this approach was documented in four control patients with benign ovarian cysts and in two patients who were imaged using both specific and nonspecific radiolabeled antibody. We conclude that the intracavitary administration of 131I- or 111In-labeled HMFG2 and H17E2 is a favorable route of administration and offers significant advantages over previously reported intravenous administration for the localization of breast or ovarian metastases confined to the pleural or peritoneal cavities.
Journal of Nuclear Medicine 01/1989; 29(12):1910-5. · 5.77 Impact Factor
[show abstract][hide abstract] ABSTRACT: Immunoscintigraphy using F(ab')2 fragments of tumor-associated monoclonal antibody HMFG1 was performed in 14 patients with primary and metastatic non-small cell carcinoma of lung cancer. The antibody was conjugated with diethylenetriamine pentaacetic acid and labeled with 111In. Quality control studies showed efficient incorporation of 111In onto antibody (5 mCi/mg), no significant loss of immunoreactivity, and in vitro and in vivo stability. The optimal time for imaging was between 48 and 72 h. Following i.v. administration, serum activity fell rapidly (t1/2a = 2.5 +/- 1.3 (SD) h; t1/2b = 42 +/- 4.5 h). The majority of the radioactivity was associated with the plasma and not with the blood cells. All patients had a significant concentration of 111In in the liver (approximately 20% of the injected dose, 48 h postadministration). No toxicity was encountered. No human antimurine-IgG antibody was detected in any of the patients within 4 months of follow-up, even in patients receiving two administrations of F(ab')2 fragments. Localization of all primary lesions and the majority (80%) of metastatic lesions was achieved. Seven of 14 patients were also studied using a 111In-labeled nonspecific antibody (Fab')2 fragment (4C4). In three patients the specificity index was higher than the other four (P less than 0.05). We conclude that although successful targeting of 111In-labeled (Fab')2 fragments of HMFG1 can be achieved in patients with non-small cell carcinoma of lung, observable tumor localization can also be achieved using a nonspecific antibody. Based on these findings, we recommend that in order to demonstrate specific radioimmunolocalization, patients with lung and possibly other tumor types should be studied using both specific and nonspecific antibodies.
Cancer Research 05/1988; 48(7):1977-84. · 8.65 Impact Factor
[show abstract][hide abstract] ABSTRACT: 131I-labelled HMFG2 or HMFG1 F(ab')2 monoclonal antibody (MAb) was administered intraperitoneally to 15 patients with epithelial ovarian cancer who had completed chemotherapy and were in complete or good partial remission. Each patient received 2-3 mCi. Patients were scanned immediately after and until 7 days post-injection. In 3/15 patients the immunoscan failed because extensive adhesions from the previous surgery prevented MAb diffusion. Of the remaining 12 patients, 9 underwent second-look laparotomy (SL). Immunoscan was true positive in 8/9 (89%) patients and equivocal in 1/9 (11%), whereas the abdominal CT scan gave true positive results in 6/9 (67%) patients. In 8 out of 9 patients there was a good correlation between distribution of all sites of abnormal uptake and the surgical findings at SL. Of the 3 patients not undergoing SL, the immunoscan was positive in all, whereas clinical examination and abdominal CT scan were negative. All 3 patients relapsed after 3, 4 and 5 months. Thus the total true positivity of immunoscan reached 92%, CT scan remaining at 50%. Immunoscan with intraperitoneal administration of 131I-labelled MAbs can thus accurately detect the presence of residual disease in ovarian cancer patients and appears more sensitive than abdominal CT scan.
International journal of cancer. Supplement = Journal international du cancer. Supplement 02/1988; 3:83-8.
[show abstract][hide abstract] ABSTRACT: Radiolabelled specific monoclonal antibodies (MAbs) HMFG2 and HMFG1 F(ab')2 and non-specific 11.4.1 and 4C4 F(ab')2 were injected into the webs between the 2nd and 3rd fingers of both hands in 31 patients with clinical diagnosis of breast cancer. We studied 10 patients with clinically obvious axillary lymph-node disease (group A) and 10 patients with clinically negative axilla (group B) using HMFG2, 5 patients with clinically negative axilla (group C) using HMFG1 F(ab')2 and 6 patients with clinically positive axilla (group D) using non-specific 11.4.1 and 4C4 F(ab')2 MAbs. In group A, 7 patients had true positive scans. There were also 3 false negative scans, due to problems related to proper iodination at the beginning of this study. In group B there were 4 true positive scans, 4 true negative, I false positive and I false negative. In group C there were 4 true negative scans. In one patient the radiolabelled antibody was arrested in the middle of the arm, because of lymphatic obstruction. In group D, there were 3 false negative scans with 11.4.1 antibody and 3 false negative scans with 4C4 F(ab')2 MAb. The results of immunoscintigraphy were in accordance with the histopathology and immunoperoxidase staining findings. These results indicate that this non-invasive approach can accurately detect metastatic involvement in the axillary lymph nodes and can be used for the diagnosis and staging of breast cancer.
International journal of cancer. Supplement = Journal international du cancer. Supplement 02/1988; 3:89-95.