Subject(s)
Antibodies, Monoclonal/therapeutic use , Brain Neoplasms/radiotherapy , ErbB Receptors/immunology , Glioma/radiotherapy , Immunoconjugates/therapeutic use , Iodine Radioisotopes/therapeutic use , Radioimmunotherapy , Adult , Antibodies, Monoclonal/administration & dosage , Astrocytoma/radiotherapy , Glioblastoma/radiotherapy , Humans , Immunoconjugates/administration & dosage , Immunoglobulin G/administration & dosage , Immunoglobulin G/therapeutic use , Injections, Intravenous , Iodine Radioisotopes/administration & dosage , Middle Aged , Neoplasm Recurrence, Local/radiotherapy , Radiotherapy Dosage , Radiotherapy, Adjuvant , Survival RateABSTRACT
Fifty-nine patients with primary presentation of high-grade gliomas of the brain, 13 with astrocytomas with anaplastic foci and 46 with glioblastoma multiforme, were treated with surgical intervention and definitive postoperative radiation therapy followed by multiple intravenous administration of iodine-125-labeled monoclonal antibody-425, which binds specifically to human epidermal growth factor receptor. The total cumulative labeled antibody doses ranged from 40 to 296 mCi. The administration of the radiolabeled antibody was performed in most instances within 3 months following completion of the primary surgery and radiation therapy. No significant life-threatening toxicities were observed during the trial. At one year, 34 (58%) of the 59 patients in the trial were alive. The median overall survival for both groups was 13.5 months.
Subject(s)
Adjuvants, Immunologic/therapeutic use , Antibodies, Monoclonal/therapeutic use , Astrocytoma/radiotherapy , ErbB Receptors/immunology , Iodine Radioisotopes/therapeutic use , Supratentorial Neoplasms/radiotherapy , Adult , Aged , Female , Glioblastoma/radiotherapy , Humans , Male , Middle Aged , Radiotherapy, AdjuvantABSTRACT
In 1986, a pilot Phase I/II project was initiated using Iodine-125 labeled anti-epidermal growth factor receptor-425 in the treatment of patients with recurrent glioblastoma multiforme of the brain. The monoclonal antibody was administered intra-arterially by the internal carotid arterial system or the vertebral arterial system depending upon the blood supply to the tumor. The treatment program was repeated at intervals for two or three times. Demonstrated was the intense localization of the monoclonal antibody in the brain tumor prior to therapy using Indium-111 labeled anti-epidermal growth factor receptor-425. This localization was demonstrated prior to any therapy as well as after failure from primary radiation therapy with or without concomitant chemotherapy. To date, 15 patients have been treated following recurrence of their glioma (1/15 metastatic adenocarcinoma) with the monoclonal antibody labeled with Iodine-125. Of the 15 patients, there has been one surgically documented complete response, two partial responders, and five patients with stable disease. The results indicate the potential activity of this radiolabeled monoclonal antibody and have prompted continued accession of patients into a Phase II study as a part of the primary treatment regimen (surgery, radiation therapy with or without chemotherapy) followed by administration of the Iodine-125 labeled anti-epidermal growth factor receptor-425.
