ABSTRACT
PURPOSE: Radioimmunotherapy with alpha-particle-emitting nuclides, such as 213Bi, is a promising concept for the elimination of small tumour nodules or single disseminated tumour cells. The aim of this study was to investigate cellular damage and the mode of cell death triggered by 213Bi-immunoconjugates. METHODS: Human gastric cancer cells (HSC45-M2) expressing d9-E-cadherin were incubated with different levels of activity of 213Bi-d9MAb targeting d9-E-cadherin and 213Bi-d8MAb, which does not bind to d9-E-cadherin. Micronucleated (M) cells, abnormal (A) cells and apoptotic (A) [(MAA)] cells were scored microscopically in the MAA assay following fluorescent staining of nuclei and cytoplasm. Chromosomal aberrations were analysed microscopically following Giemsa staining. The effect of z-VAD-fmk, known to inhibit apoptosis, on the prevention of cell death was investigated following treatment of HSC45-M2 cells with sorbitol as well as 213Bi-d9MAb. Activation of caspase 3 after incubation of HSC45-M2 cells with both sorbitol and 213Bi-d9MAb was analysed via Western blotting. RESULTS: Following incubation of HSC45-M2 human gastric cancer cells expressing d9-E-cadherin with 213Bi-d9MAb the number of cells killed increased proportional to the applied activity concentration. Microscopically visible effects of alpha-irradiation of HSC45-M2 cells were formation of micronuclei and severe chromosomal aberrations. Preferential induction of these lesions with specific 213Bi-d9MAb compared with unspecific 213Bi-d8MAb (not targeting d9-E-cadherin) was not observed if the number of floating, i.e. unbound 213Bi-immunoconjugates per cell exceeded 2 x 10(4), most likely due to intense crossfire. In contrast to sorbitol-induced cell death, cell death triggered by 213Bi-immunoconjugates was independent of caspase 3 activation and could not be inhibited by z-VAD-fmk, known to suppress the apoptotic pathway. CONCLUSION: 213Bi-immunoconjugates seem to induce a mode of cell death different from apoptosis in HSC45-M2 cells.
Subject(s)
Antibodies, Monoclonal/administration & dosage , Apoptosis/radiation effects , Bismuth/administration & dosage , Chromosome Aberrations/radiation effects , Radioisotopes/administration & dosage , Stomach Neoplasms/pathology , Stomach Neoplasms/radiotherapy , Alpha Particles , Cell Line, Tumor , Dose-Response Relationship, Radiation , Humans , Micronuclei, Chromosome-Defective/radiation effects , Radiation Dosage , Radioimmunotherapy/methods , Radiopharmaceuticals/administration & dosage , Stomach Neoplasms/genetics , Treatment OutcomeABSTRACT
PURPOSE: The locoregional application of tumor-specific antibodies conjugated with highly cytotoxic alpha-emitters is a promising new strategy for therapy of i.p. tumor cell dissemination. Using this approach, an antibody specifically targeting diffuse-type gastric cancer cells was coupled to the high linear energy transfer alpha-emitter (213)Bi for treatment of i.p. tumor cell spread in a nude mouse model. EXPERIMENTAL DESIGN: Nude mice were inoculated with HSC45-M2 human gastric cancer cells expressing mutant d9-E-cadherin. Twenty-four h after cell inoculation, mice received i.p. injections of either (213)Bi-d9MAb specifically binding to mutant d9-E-cadherin of HSC45-M2 cells or unspecific (213)Bi-d8MAb (7.4 or 22.2 MBq). Survival of treated animals was monitored compared with controls that had been injected with nonlabeled monoclonal antibody (MAb) or saline. Toxicity was evaluated by WBC counts after injection of 1.85, 7.4, or 22.2 MBq and analysis of chromosomal aberrations of bone marrow cells after injection of 7.4, 14.8, or 22.2 MBq. RESULTS: Survival rates of control mice and of mice treated with (213)Bi-MAbs differed significantly: the mean survival of untreated controls and mice that were given the nonlabeled antibody was 23 and 26 days. After injection of 22.2 MBq of the specific (213)Bi-d9MAb or the unspecific (213)Bi-d8MAb, mean survival was at least 143 or 130 days, respectively. Treatment with 7.4 MBq of (213)Bi-d9MAb increased mean survival to at least 232 days and with (213)Bi-d8MAb to at least 172 days. WBC counts decreased within 2 days after (213)Bi-therapy but reached pretreatment values between day 14 and 21 after activity injection. Chromosomal aberrations in bone marrow cells could only be detected at day 1 after (213)Bi-therapy. The frequency of chromosomal damages increased depending on the applied (213)Bi-activity. CONCLUSIONS: The therapeutic efficacy of the (213)Bi-d9MAb together with a low bone marrow toxicity support the locoregional therapy for that subgroup of diffuse-type gastric carcinoma patients expressing d9-E-cadherin.
