High yield direct 76Br-bromination of monoclonal antibodies using chloramine-T

Monoclonal antibody (MAb) A33 was labeled with the positron emitter 76Br (T(1/2) = 16.2 h). Direct labeling was done using the conventional chloramine-T method. After optimization of the labeling conditions, a maximum yield (mean +/- max error) of 77 +/- 2% was obtained at pH 6.8. In vitro binding of 76Br-A33 to SW1222 colonic cancer cells showed that the immunoreactivity was retained. Also, the MAbs 38S1 and 3S193 and the peptide hEGF were 76Br-labeled, resulting in labeling yields (mean +/- max error) of 75 +/- 3%, 63 +/- 4%, and 73 +/- 0.1%, respectively. We conclude that antibodies and peptides can be labeled conveniently with 76Br for the purpose of whole-body tumour imaging by positron emission tomography.     

Optimized indirect (76)Br-bromination of antibodies using N-succinimidyl para-[76Br]bromobenzoate for radioimmuno PET

Monoclonal antibody 38S1 was radiobrominated with the positron emitter ⁷⁶Br (T_1/2= 16.2 h). Indirect labeling was performed using N-succinimidyl para-(tri-methylstannyl)benzoate (SPMB) as the precursor molecule. SPMB was labeled using Chloramine-T yielding N-succinimidyl para-[⁷⁶Br]bromobenzoate, which was then conjugated to the antibody. Optimization of the labeling conditions and further conjugation gave a total yield ( mean±max error) of 49±2%. The immunoreactivity of the antibodies was retained after labeling. Thus, antibodies intended for positron emission tomography can be labeled with ⁷⁶Br, which gives high yields and preserved immunoreactivity when using the SPMB technique described.     

Breast cancer imaging with mouse monoclonal antibodies

The localization of ¹¹¹In-labelled MA5 monoclonal antibody, reactive with a breast tumor associated antigen, was studied in 17 patients. MA5 was selected because 1) it reacts with >95% of primary and metastatic lesions, 2) the recognized antigen is present on the cell surface in vivo and 3) MA5 gives excellent localization in human breast tumor xenografts. Each patient received 2 mg antibody labeled with 5 mCi ¹¹¹In and in some cases, 3 mg or 18 mg unlabeled carrier antibody. No serious allergic reactions were noted. There was a large uptake in the liver, less significant uptake in the spleen and bone, and minimal accumulation in the bowel. Bone lesions, primary tumors, soft tissue recurrences and lung metastases larger than 3 cm diameter were imaged, while only 1 lesion smaller than 3 cm was detected. Non specific accumulation of tracer was noted at the site of a port-a-cath, in a hematoma, in fibrocystic lesions, and at sites of previous radiation treatment. Extensive fibrosis and poor vascularization characteristic of breast tumors may explain in part the limited sensitivy of the imaging.     

Pharmacokinetic study of radiolabeled anti-colorectal carcinoma monoclonal antibodies in tumor-bearing nude mice

Monoclonal antibodies (MoAbs) 17-1A and 19-9, which specifically bind human colorectal carcinoma (CRC) cells, were tested for their usefulness in localizing colorectal tumors in nude mice. One of the ¹³¹I-labeled MoAbs and an irrelevant ¹²⁵I-labeled immunoglobulin of the same isotype were injected into nude mice simultaneously bearing a human CRC and a human melanoma. The percentage of the injected dose of antibody per gram of tissue, the CRC/tissue ratios of antibody distribution, and the localization indices were calculated at various time intervals (2 h to 9 days). For both MoAbs, labeling to a specific activity of 10 Ci/g by the iodogen method gave optimum immunoreactivity. The accumulation of MoAb 17-1A in CRC reached its maximum at 5 days and remained at this level for up to 9 days postinjection. For MoAb 19-9, which detects a circulating antigen shed by the tumor into the serum, the accumulation in the CRC was maximum at 24 h, and decreased thereafter. The CRC/organ ratios and localization indices for both MoAbs increased with time in the CRC tissue, but remained low and unchanged in the melanoma and normal tissues. Using F(ab)₂ antibody fragments, faster kinetics with earlier maximum accumulation, higher tumor/organ ratios, and better localization indices were achieved than with intact MoAbs. The data obtained was useful in defining parameters which must be considered before radiolabeled MoAbs are used in cancer patients for diagnostic purposes.     

Evaluation of monoclonal idiotypic-specific antibodies as clearing antibodies for enhancement of target localisation by tumour-specific monoclonal antibodies: diversity of effects in nude mice with human tumour xenografts

Three tumour-specific monoclonal antibodies (MoAbs) showed localisation in human tumour xenografts in nude mice, although the tumour discrimination was limited by the survival of a greater proportion of the MoAb in the blood and body as a whole. An attempt was made to increase tumour discrimination by the subsequent administration of syngeneic idiotypic-specific MoAbs (anti-id) directed against the first antibodies, in the expectation of clearing excess of the first MoAb from the circulation. With one MoAb (NCRC-2), its anti-id (NCRC-60) did effectively clear it from the blood, and, at least within a few hours, the tumour-to-blood ratios were increased. After longer periods, however, the tumour levels of NCRC-2 were also reduced, and the tumour discrimination was no longer increased. With another MoAb (NCRC-23) the tumour levels were reduced to a greater extent than were the blood levels in mice treated with its anti-id (NCRC-59), so that rather than being increased the tumour discrimination was actually reduced to about a third of that in control mice. With a third MoAb (NCRC-48), there was no effect on the tumour or blood levels within a few hours of injection of its anti-id (NCRC-62), and so there was no short-term effect on tumour discrimination. Subsequently, however, the tumour levels were slightly reduced, while the blood levels increased in mice treated with anti-id compared with control mice, so that the tumour-to-blood ratios decreased. These studies have shown a variety of effects of syngeneic anti-id MoAbs on tumour discrimination by their target MoAbs, and overall the indication is that such anti-ids selected indiscriminately are likely to be of little value for enhancing target recognition by murine or human MoAbs given for diagnostic or therapeutic purposes. Offprint requests to: M.V Pimm     

Anomalies in reduction-mediated technetium-99m labelling of monoclonal antibodies

A reduction-mediated technetium-99m labelling method has been evaluated with a range of tumour-specific monoclonal antibodies. Antibodies reduced with 2-mercaptoethanol (2-ME) had free sulphydryl groups, but their number was much higher than could be accounted for by only limited intra-chain reduction of disulphide bonds. Reduced antibody could be labelled efficiently with ^99mTc using an methylene diphosphonate (MDP) bone-scanning kit, although this seemed to depend on the presence of residual 2-ME in the preparations. With a carcinoembryonic antigen (CEA)-specific antibody, immunoreactivity of labelled antibody was confirmed, and after injection into nude with CEA-producing xenografts there was localisation into the tumours. Sephacryl S300 gel filtration showed the radiolabel eluting at a single discrete peak at the expected 150 kDa. However, examination of all of the labelled antibodies by polyacrylamide gel electrophoresis (PAGE) and autoradiography showed the presence of a large number of radiolabelled low molecular weight degradation products of the antibodies. These degradation products seemed to be formed in previously reduced antibodies during processing for PAGE, indicating some fragility of the reduced antibody. Offprint requests to: M.V. Pimm     

Histological correlation of 17 prospective immunoscintigraphies of recurrences of colorectal carcinomas using indium-111-labeled anti-cea and(or) 19-9 monoclonal antibodies

Seventeen patients (mean age 55 years) with suspected recurrence in previously operated and histologically confirmed colorectal adenocarcinomas were explored by immunoscintography (IS) associating planar and emission computed tomography (ECT) and using the ¹¹¹In-labeled anti carcinoembryonic antigen (CEA) and(or) 19-9 monoclonal antibodies (MoAbs). The results of IS were compared blind with those of computed tomography (CT) and ultrasonography (US). The final diagnosis of recurrence and(or) metastasis was done in 16 cases by second-look surgery and in another patient by rectal biopsy. Overall per-patient sensitivity for the pelvis and extrahepatic abdomen was 69% for IS and 31% and 25% respectively for computed tomography and ultrasonography. No false positive of IS, as well as US and CT, for the pelvis and the extrahepatic abdomen was seen. Based on the number of anatomical sites tested, sensitivity of IS was 91% in the pelvis. In our series, scintigraphic computer subtraction did not allow adequate resolution of the problem of intense liver uptake of ¹¹¹In-labeled MoAbs. It is concluded that IS using ¹¹¹In-labeled anti CEA and(or) 19-9 MoAbs should be carried out prospectively in patients at high risk of recurrence of colorectal cancer.     

Comparison of non-invasive approaches to red marrow dosimetry for radiolabelled monoclonal antibodies

Red marrow is usually the dose-limiting organ during radioimmunotherapy. Several non-invasive approaches to calculate the red marrow dose have been proposed. We compared four approaches to analyse the differences in calculated red marrow doses. The data were obtained from immunoscintigraphy of two antibodies with different red marrow kinetics [iodine-131-16.88 IgM and indium- 111-OV-TL-3 F(ab)₂]. The approaches are based on, respectively, homogeneously distributed activity in the body, a red marrow-blood activity concentration ratio of 0.3, scintigraphic quantification, and a combination of the second and third approaches. This fourth approach may be more adequate because of its independence from the chosen antibody. In addition, the influence of activity accumulation in liver, kidneys or cancellous bone on red marrow dose was studied. The calculated red marrow dose varied between 0.14 and 0.42 mGy/MBq for ¹¹¹ In-OV TL-3 and between 0.13 and 0.68 mGy/MBq for ¹³¹I-16-88. If the radiopharmaceutical shows high affinity for cancellous bone or another organ situated near the red marrow, the activity in these organs must be included in dose calculations. This study shows a large variation in calculated red marrow dose and selection of the definitive non-invasive approach awaits validation. Correspondence to: M.A.B.D. Plaizier     

Optimized indirect br-bromination of antibodies using n-succinimidyl para-[br]bromobenzoate for radioimmuno PET

Monoclonal antibody 38S1 was radiobrominated with the positron emitter ⁷⁶Br (T_1/2 = 16.2 h). Indirect labeling was performed using N-succinimidyl para-(tri-methylstannyl)benzoate (SPMB) as the precursor molecule. SPMB was labeled using Chloramine-T yielding N-succinimidyl para-[⁷⁶Br]bromobenzoate, which was then conjugated to the antibody. Optimization of the labeling conditions and further conjugation gave a total yield ( mean±max error) of 49±2%. The immunoreactivity of the antibodies was retained after labeling. Thus, antibodies intended for positron emission tomography can be labeled with ⁷⁶Br, which gives high yields and preserved immunoreactivity when using the SPMB technique described.     

Labelling monoclonal antibodies with Yttrium-90

Using the cyclic DTPA derivatisation procedure developed by Hnatowich, conditions have been optimised for labelling three tumour-associated monoclonal antibodies with ⁹⁰Y. High labelling efficiencies (>95%) at modest specific activities (1 mCi/mg) could be routinely obtained. Radiochemical stability of the radiolabelled preparations in vitro was good, but radiolysis resulted in early losses of antibody immunoreactivity.Abbreviations PBS Phosphate buffered saline - BSA Bovine Serum Albumin - HSA Human Serum Albumin - ITLC Instant thin layer chromatography - HPLC High pressure liquid chromatography - CAE Cellulose acetate electrophoresis - ELISA Enzyme linked immunosorbent assay - RIA Radioimmune assay - DTPA Diethylenetriaminepentaacetic acid     

Radiolabelled monoclonal antibodies against alpha-fetoprotein for in vivo localization of human hepatocellular carcinoma by immunotomoscintigraphy

Two high affinity monoclonal antibodies, designated AF01 and AF04, directed against distinct epitopes of human alpha-fetoprotein (AFP) and the Fab fragments of one of them, were labelled with ¹³¹I and injected into 18 patients with AFP producing hepatocellular carcinoma (HCC) in order to carry out imaging studies by tomoscintigraphy. Twelve patients were injected with whole antibody, only three of seven patients injected with AF01 and two of five patients injected with AF04 had a positive scan. In contrast, five out of six patients injected with labelled Fab fragments of AF04 had positive imaging. These results confirm that tumour imaging of HCC using ¹³¹I labelled monoclonal antibody against AFP is feasible. Moreover, utilization of tomoscintigraphy in place of linear scintigraphy and Fab fragments instead of whole immunoglobulin may improve the sensitivity of radioimmunolocalization. This technique provides useful information on the in vivo distribution of monoclonal antibodies directed against AFP and on the practicability of the eventual therapeutic use of anti-AFP antibodies in HCC.This work was supported by Grant number 84D16 from the Institut Gustave-Roussy     

Positron emission tomography of experimental melanoma with

Positron emission tomography (PET) has evolved as a new diagnostic modality in cancer patients. Thioureylenes, such as thiouracil and methimazole, are known to be incorporated into growing melanin and selectively retained in melanotic melanoma. In the present study we used [⁷⁶Br]5-bromo-2-thiouracil as tracer for PET imaging of human and murine melanotic melanoma transplanted subcutaneously into rats. The melanomas were clearly depicted 1 day after the injection, when [⁷⁶Br]5-bromo-2-thiouracil was retained in the tumors though the overall radioactivity concentration in the body had declined. Accumulation of ⁷⁶Br was also seen in bladder, liver, and kidney. In addition, the rats were simultaneously injected with [¹²⁵I]5-iodo-2-thiouracil and the tissue distribution of radioactivity was mapped by whole-body autoradiography. The results confirmed the selective uptake of thiouracil in the melanoma where the concentration of ¹²⁵I-radioactivity was about three-fold higher than that in the liver and lungs. These results show the possibility of using [⁷⁶Br]5-bromo-2-thiouracil for PET diagnostics of melanoma, including dosimetry, prior to targeted therapy using [¹³¹I]5-iodo-2-thiouracil or [²¹¹At]5-astato-2-thiouracil.     

White blood cell scintigraphy with monoclonal antibodies in the study of the infected endoprosthesis

Forty-three patients with suspected infection of a hip or a knee prosthesis were studied with white blood cell scintigraphy (WBC), using technetium-99m (n = 37) or iodine-123 (n = 6) labelled monoclonal mouse antibody (MoAb). Previously, all patients had undergone skeletal scintigraphy, which was performed as a three-phase study in 33 cases. The final diagnosis was established by open surgery, histology and culture in 37 cases, by puncture and culture in 3 cases, and by clinical follow-up of at least 6 months in 3 cases. Eighteen prostheses were infected, 25 uninfected. The delayed phase of skeletal scintigraphy had a sensitivity of 92%, a specificity of 24% and an accuracy of 48% in the detection of infection. The perfusion and blood pool activity of the three-phase bone scan had a sensitivity of 67%, a specificity of 71% and an accuracy of 70%. The diagnostic value of WBC was sensitivity 89%, specificity 84% and accuracy 86%. WBC with ^99m-Tc-MoAb is easy to perform and always available. Its diagnostic accuracy is similar to conventional WBC scintigraphy with either indium-111 or technetium-99m. Offprint requests to: J. Sciuk     

人附睾蛋白4单克隆抗体与免放试剂盒的制备及其对卵巢癌诊断的临床价值探讨

目的 制备人附睾蛋白4(HE4)单克隆抗体并研制免放分析试剂盒, 探讨其在卵巢癌临床诊断中的价值。 方法 用重组人HE4免疫小鼠, 通过细胞融合杂交瘤技术制备并筛选可以配对的HE4单抗, 用125I标记其中一株单抗, 研制HE4免放试剂盒, 并评价其检测的灵敏度。通过检测临床血清标本来评价其对卵巢癌诊断的灵敏度和特异度。 结果 筛选出了一对亲和力与特异性高的HE4单抗, 其免放试剂盒检测的灵敏度为3.65 pmol/L, 其对卵巢癌的临床诊断的灵敏度可达90.83%, 特异度为99.17%。 结论 制备的单克隆抗体亲和力高, 研制的免放试剂盒各项指标较好, 可用于卵巢癌的早期临床诊断和疗效观察, 降低卵巢癌患者的病死率。     

Multi-centre immunoscintigraphic study using indium-111-labelled CEA-specific and/or 19-9 monoclonal antibody F(ab′)2 fragments

Six European nuclear medicine centres per formed immunoscintigraphy first retrospectively in 34 patients using indium-111-labelled carcinoembryonic antigen (CEA)-specific and/or 19-9 F(ab')₂ fragments. Results for sensitivity and specificity in tumour sites were 94% and 87%, respectively, for the pelvis and 73% and 100% for the extrahepatic abdomen. A second prospective series concerned 58 other patients previously operated on for colorectal adenocarcinoma (27 colon, 31 rectum). Two-thirds of these patients had a suspected recurrence signalled by an isolated rise in tumour markers, and 46 patients examined by immunoscintigraphy, X-ray computed tomography and ultrasonography were found to have a recurrence (a total of 62 tumour sites). Sensitivity and specificity with immunoscintigraphy were 90% and 97%, respectively, for the pelvis and 62% and 95% for the extrahepatic abdomen. For 29 patients injected with CEA-specific fragments, sensitivity was 90% and specificity 94% for the pelvis. For 25 patients injected with 19-9 fragments, pelvic sensitivity and specificity were 80% and 100%, respectively, whereas sensitivity for the extrahepatic abdomen was only 29% since several cases of peritoneal carcinosis were not visualized. In the prospective series, comparison of the three imaging techniques for all tumour sites (including liver and in 5 cases thorax) gave a sensitivity and specificity of 82% and 91 %, respectively, for immunoscintigraphy, 52% and 95% for X-ray computed tomography and 59% and 100% for ultrasonography. These results thus confirm the advantage of using¹¹¹In-labelled CEA-specific or 19-9 to visualize and localize recurrences of colorectal cancer.This study was presented in part at the congress of the European Association of Nuclear Medicine in Strasbourg, France, on August 31, 1989, and has appeared in abstract form (Eur J Nucl Med (1989) 15:438)     

抗A型肉毒毒素鼠源性单克隆抗体的制备和鉴定

目的：制备与鉴定抗A型肉毒神经毒素重链C端（ heavy chain of botulinum neurotoxin serotype A, BoNT／AHc）特异性鼠单克隆抗体。方法通过纯化BoNT／AHc抗原、免疫BALB／c小鼠并建立杂交瘤细胞以制备鼠单抗,用ELISA、Western印迹实验和抗体分型试剂盒进行分析鉴定,并通过ELISA检测鼠单抗与BoNT／AHc突变体结合,初步鉴定其在BoNT／AHc的结合表位。结果得到纯度较高的BoNT／AHc抗原,制备了4株特异性鼠单抗1A4、3H3、3H7、5H8。间接ELISA结果显示,单抗细胞上清效价均＞3．0×103;Western印迹检测结果显示,单抗均能与BoNT／AHc特异性结合;抗体亚型鉴定结果为1A4、3H7属于IgG1（Κ）,3H3属于IgM（Κ）,而5H8属于IgG2b （Κ）;叠加ELISA实验表明,4株单抗抗原识别表位相近;用ELISA检测单抗与BoNT／AHc突变体结合实验结果初步确定了4株单抗与BoNT／AHc的结合表位。结论对抗A型肉毒毒素鼠源性抗体完成了制备和鉴定,为肉毒毒素中和抗体的开发与阐明中和抗体的表位奠定了基础。     

Two-step tumour targetting in ovarian cancer patients using biotinylated monoclonal antibodies and radioactive streptavidin

A new method for intraperitoneal tumour targetting in ovarian cancer using biotinylated monoclonal antibodies (MoAb) and radioactive streptavidin is described. Fifteen patients with histologically documented ovarian carcinoma were injected intraperitoneally with 2 mg of biotinylated MoAb MOv18, followed 3–5 days later by 100–150 g of indium-111 streptavidin, at the specific activity of 280–370 MBq/mg in 500 ml of normal saline. No toxicity was observed. Tumours were imaged from 2 to 48 h after radioactivity injection by recording both planar and single photon emission tomography (SPET) data. All patients underwent surgery 1–8 days later (mean 3 days) after scanning. The resected tumour and normal tissue radioactivity were measured. On the day of surgery, the tumour to normal tissue ratio was 9:1 (range 3:1–30:1) and 45:1 (range 12:1–120:1) for intra- and extraperitoneal samples, respectively. The mean tumor to blood ratio was 14:1 (range 4:1–30:1). The injected dose (i.d.) per gram of tumour was 0.112 (range 0.01–0.3) for recurrences and 0.05 for primary tumour (range 0.005–0.2). Over 24–48 h 14% i.d. (range 8–18% i.d.) was found in the urine, 14% i.d. (range 629% i.d.) in the blood and 63% i.d. (range 56–70% i.d.) was still in the peritoneal cavity. These preliminary clinical data suggest that this two-step strategy may be superior to the conventional approach (radiolabelled antibodies) for intraperitoneal radioimmunolocalization and radioimmunotherapy of ovarian cancer. Offprint requests to: G. Paganelli     

The impact of tumour volume and other characteristics on uptake of radiolabelled monoclonal antibodies in tumour tissue of head and neck cancer patients

Radioimmunotherapy (RIT) seems to be a realistic option for eradication of minimal residual squamous cell carcinoma of the head and neck (HNSCC), although uptake levels of radiolabelled monoclonal antibodies (MAbs) in tumour tissue vary strongly. The aim of this study was to obtain greater insight into the factors influencing the accumulation of MAbs in HNSCC. Twenty-seven HNSCC patients were injected with radiolabelled MAb E48 or U36 and underwent surgery 2 days after injection. Radioactivity was measured in tumour biopsies taken from the surgical specimen. Uptake levels were correlated with various patient, tumour and MAb characteristics, including age, sex, site, TNM stage, volume as assesssed by computed tomography or magnetic resonance imaging, degree of differentiation, antigen expression of the tumour, the particular MAb that had been injected and the MAb dose. A stepwise regression multivariate analysis showed that tumour volume is the most significant prognostic factor (P=0.01) for MAb uptake. In conclusion, a significantly higher MAb uptake is found in small tumours as compared to larger tumours. Therefore, RIT may be particularly effective in head and neck cancer patients when used in an adjuvant setting. Received 3 August 1998     

钆标记抗人肝癌单克隆抗体瘤内注射对荷瘤裸鼠的磁共振增强试验

探讨小剂量瘤内注射钆标记抗人肝癌单克隆抗体的磁共振增强效应。方法应用ＤＴＰＡ环酐双向偶合剂制出Ｇｄ－ＤＴＰＡ－ＭｃＡｄｓ;实验组４只荷肝癌裸鼠直接瘤内注入３０μｇ单克隆抗体量的Ｇｄ－ＤＴＰＡ－ＭｃＡｄｓ;对照射向瘤内注入３０μｇ单克隆抗体的生理盐水,１２ｈ后加权像扫描。     

Dosimetry of intrathecal iodine131 monoclonal antibody in cases of neoplastic meningitis

Radioiodinated monoclonal antibodies (MCA) were administered by the lumbar route into the cerebrospinal fluid (CSF) of four patients with malignant leptomeningeal disease. Evidence suggesting uptake of¹³¹I-MCA by tumour sites was seen in scintigrams. Dosimetry calculations were carried out, assuming that a proportion of the administered radionuclide was bound as a thin layer on the CSF surfaces of the meninges. The percentage injected dose and the clearance curves for the head and four spinal segments were obtained by scintigraphy after administration of tracer amounts of¹³¹I-MCA (7–18 MBq). Although radioisotope levels in the central nervous system (CNS) fell, as determined by both external scintillation counting and direct CSF sampling, a marked difference in the measurements developed with respect to time. The ratio of these two measurements reached a maximum of 49:1, 7 days after monoclonal antibody administration. Patients subsequently received therapeutic amounts (870–1600 MBq) of¹³¹I-MCAs, resulting in clinical remissions and prolonged survival. The mean absorbed radiation dose was estimated as 3.9 cGy·MBq^–1 to the thoraco-lumbar region of the spine and 0.51 cGy·MBq^–1 to the outer surface of the brain. The maximal dose delivered to the surface of the CNS in the region of the spine and brain was 5800 and 600 cGy, respectively.