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Immunoscintigraphy with a new indium-111-labeled monoclonal antibody (MAb 1A3) in patients with colorectal cancer

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Diseases of the Colon & Rectum

Abstract

PURPOSE: This study was designed to evaluate a new anticolorectal carcinoma monoclonal antibody (1A3), conjugated with the bifunctional chelating agent N,N′-bis (2-hydroxybenzyl) 1 (4-bromoacetamidobenzyl) 1,2-ethylenediamine-N,N′-diacetic acid and labeled with indium-111, in a Phase I/II study involving 38 patients with localized or advanced colorectal cancer. METHODS: Patients were injected with indium-111-N,N′-bis(2-hydroxybenzyl) 1 (4-bromoacetamidobenzyl) 1,2-ethylenediamine-N, N′-diacetic acid-monoclonal antibody 1A3 (1–50 mg, 1–5 mCi) and imaged at two or three sessions one to five days later. Scintigraphic findings were compared with radiologic, pathologic, surgical, and other clinical findings to assess the accuracy of radioimmunoscintigraphy. RESULTS: At least one known tumor site was clearly defined by planar scintigraphy in 29 (76 percent) patients. Increased radioactivity was seen in 40 of 63 known tumor sites (37/43 abdominal-pelvic, 3/15 hepatic, and 0/5 pulmonary sites) without any apparent dose-related effects. Nineteen previously undetected sites were considered positive by imaging, and, of these, six were biopsy-proven tumor sites, four were probable tumor sites, three were definitely false positive sites, and six were probable false positive sites. Radioimmunoscintigraphy detected proven tumor in 15 of 16 patients with negative or equivocal computed tomography results. Of the 28 patients with rectosigmoid cancer, 25 (89 percent) had positive studies with 34 of 47 tumor sites showing definite uptake on the scintigrams. This included 3 of 9 hepatic metastases. The only adverse reaction occurred in one patient who developed transient hives. Human anti-mouse antibody responses occurred in approximately one-half of the patients injected with doses of 10 or 50 mg. CONCLUSION: This study shows that radioimmunoscintigraphy with this indium-111-labeled monoclonal antibody is safe, it can detect most nonhepatic abdominalpelvic tumors with a positive predictive value of 83 (44/ 53) percent, and it should prove to be useful, particularly in the diagnosis of recurrent rectal carcinoma.

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Authors and Affiliations

  1. Department of Surgery, The Jewish Hospital of St. Louis, 216 South Kingshighway Boulevard, 63110, St. Louis, Missouri

    Gordon W. Philpott M.D., Judith M. Connett Ph.D., James W. Fleshman M.D. & Mary Baumann B.S.

  2. Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri

    Barry A. Siegel M.D., Sally W. Schwarz M.S., R.Ph., Pamela A. Rocque B.S., Jerold W. Wallis M.D. & Michael J. Welch Ph.D.

  3. Texas A & M University, College Station, Texas

    Yizhen Sun Ph.D. & Arthur E. Martell Ph.D.

Authors
  1. Gordon W. Philpott M.D.
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  2. Barry A. Siegel M.D.
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  3. Sally W. Schwarz M.S., R.Ph.
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  4. Judith M. Connett Ph.D.
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  5. Pamela A. Rocque B.S.
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  6. James W. Fleshman M.D.
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  7. Jerold W. Wallis M.D.
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  8. Mary Baumann B.S.
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  9. Yizhen Sun Ph.D.
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  10. Arthur E. Martell Ph.D.
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  11. Michael J. Welch Ph.D.
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Additional information

This work was performed at the Washington University Medical Center. Supported by National Institutes of Health Grants CA44728 and CA42925 and the Roxanne and Alvin Frank Fund.

Read at the meeting of The American Society of Colon and Rectal Surgeons, Chicago, Illinois, May 2 to 7, 1993.

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Philpott, G.W., Siegel, B.A., Schwarz, S.W. et al. Immunoscintigraphy with a new indium-111-labeled monoclonal antibody (MAb 1A3) in patients with colorectal cancer. Dis Colon Rectum 37, 782–792 (1994). https://doi.org/10.1007/BF02050143

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  • DOI: https://doi.org/10.1007/BF02050143

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