Clinical radioimmunotherapy—the role of radiobiology

Abstract

Conventional external-beam radiation therapy is dedicated to the treatment of localized disease, whereas radioimmunotherapy represents an innovative tool for the treatment of local or diffuse tumors. Radioimmunotherapy involves the administration of radiolabeled monoclonal antibodies that are directed specifically against tumor-associated antigens or against the tumor microenvironment. Although many tumor-associated antigens have been identified as possible targets for radioimmunotherapy of patients with hematological or solid tumors, clinical success has so far been achieved mostly with radiolabeled antibodies against CD20 ((131)I-tositumomab and (90)Y-ibritumomab tiuxetan) for the treatment of lymphoma. In this Review, we provide an update on the current challenges aimed to improve the efficacy of radioimmunotherapy and discuss the main radiobiological issues associated with clinical radioimmunotherapy.

Advances in Anticancer Immunotoxin Therapy

“…No successful radioimmunotherapy agents have been developed for treating solid tumors. These tumors are generally much less sensitive to radiation than lymphocytes, and current targeting technology delivers insufficient radioisotope to solid tumors for adequate antitumor effect [13].…”

Defining the role for dosimetry and radiobiology in combination therapies

“…Radiobiology has been 'rediscovered' after falling out of fashion for almost 20 years, and concepts initially developed for EBRT are now being applied to MRT [7]. Radiobiology effectively consists of two aspects -that of mathematical modelling, generally based on the linear quadratic model, and biologically orientated experiments to examine the effect of radiation on tissue.…”

Emerging Trends for Radioimmunotherapy in Solid Tumors

“…2 Several articles have reviewed various other aspects of solid tumor RIT, including the role of radiobiology in tumor cell killing, clinical experience with RIT, pretargeting strategies, targeted therapies, optimization of delivery, and the use of various radionuclides for RIT. [3][4][5][6][7][8][9][10][11][12][13] Development of efficient labeling methodologies has fueled recent interest in exploiting short-range, high energy a-particle emitting radionuclides for treating solid tumors by RIT in a minimal residual disease setting. In addition to the identification and use of new antigenic targets, RIT and radioimmunoimaging strategies are also being developed using monoclonal antibodies (MAbs) that are conventionally approved as unlabeled therapeutic agents.…”