Conventional and pretargeted radioimmunotherapy using bismuth-213 to target and treat non-Hodgkin lymphomas expressing CD20: a preclinical model toward optimal consolidation therapy to eradicate minimal residual disease

Blood. 2010 Nov 18;116(20):4231-9. doi: 10.1182/blood-2010-05-282327. Epub 2010 Aug 11.

Abstract

Radioimmunotherapy (RIT) with α-emitting radionuclides is an attractive approach for the treatment of minimal residual disease because the short path lengths and high energies of α-particles produce optimal cytotoxicity at small target sites while minimizing damage to surrounding normal tissues. Pretargeted RIT (PRIT) using antibody-streptavidin (Ab-SA) constructs and radiolabeled biotin allows rapid, specific localization of radioactivity at tumor sites, making it an optimal method to target α-emitters with short half-lives, such as bismuth-213 (²¹³Bi). Athymic mice bearing Ramos lymphoma xenografts received anti-CD20 1F5(scFv)(4)SA fusion protein (FP), followed by a dendrimeric clearing agent and [²¹³Bi]DOTA-biotin. After 90 minutes, tumor uptake for 1F5(scFv)₄SA was 16.5% ± 7.0% injected dose per gram compared with 2.3% ± .9% injected dose per gram for the control FP. Mice treated with anti-CD20 PRIT and 600 μ Ci [²¹³Bi]DOTA-biotin exhibited marked tumor growth delays compared with controls (mean tumor volume .01 ± .02 vs. 203.38 ± 83.03 mm³ after 19 days, respectively). The median survival for the 1F5(scFv)₄SA group was 90 days compared with 23 days for the control FP (P < .0001). Treatment was well tolerated, with no treatment-related mortalities. This study demonstrates the favorable biodistribution profile and excellent therapeutic efficacy attainable with ²¹³Bi-labeled anti-CD20 PRIT.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Antibodies, Neoplasm / immunology
  • Antigens, CD20 / metabolism*
  • Biotin / adverse effects
  • Biotin / analogs & derivatives
  • Biotin / pharmacokinetics
  • Biotin / pharmacology
  • Biotin / therapeutic use
  • Bismuth / adverse effects
  • Bismuth / pharmacokinetics
  • Bismuth / pharmacology
  • Bismuth / therapeutic use*
  • Blood Cell Count
  • Cell Line, Tumor
  • Humans
  • Immunoglobulin Variable Region / immunology
  • Kidney / drug effects
  • Kidney / metabolism
  • Kidney / physiopathology
  • Liver Function Tests
  • Lymphoma, Non-Hodgkin / immunology*
  • Lymphoma, Non-Hodgkin / pathology
  • Lymphoma, Non-Hodgkin / physiopathology
  • Lymphoma, Non-Hodgkin / radiotherapy*
  • Mice
  • Neoplasm, Residual / drug therapy*
  • Neoplasm, Residual / immunology
  • Organometallic Compounds / adverse effects
  • Organometallic Compounds / pharmacokinetics
  • Organometallic Compounds / pharmacology
  • Organometallic Compounds / therapeutic use
  • Radioimmunotherapy / methods*
  • Radiometry
  • Recombinant Fusion Proteins / metabolism
  • Survival Analysis
  • Tissue Distribution / drug effects
  • Xenograft Model Antitumor Assays*

Substances

  • Antibodies, Neoplasm
  • Antigens, CD20
  • DOTA-biotin
  • Immunoglobulin Variable Region
  • Organometallic Compounds
  • Recombinant Fusion Proteins
  • Biotin
  • Bismuth