Imaging for improved prediction of myelotoxicity after radioimmunotherapy

DeNardo, Diane A.; DeNardo, Gerald L.; O’Donnell, Robert T.; Lim, Sang Moo; Shen, Sui; Yuan, Aina; DeNardo, Sally J.

doi:10.1002/(sici)1097-0142(19971215)80:12+<2558::aid-cncr31>3.0.co;2-9

Cited by 26 publications

(21 citation statements)

References 12 publications

(1 reference statement)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The radiation dose to the red marrow can be estimated using the activity levels in the blood (5), as long as the radiolabeled antibody does not bind specifically to the cells in the bone marrow. However, various other imaging methods to estimate the red marrow dose have been described (6)(7)(8).…”

Section: Discussionmentioning

confidence: 95%

“…DeNardo et al showed, for example, that an image-based method, unlike the blood-based method, was able to predict thrombocytopenia and leukopenia (7). In the present study, both the blood-based method and an image-based method were used to estimate the red marrow dose.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies on the relationship between radiation dose estimates and myelotoxicity were variable (7,(9)(10)(11)(12)(13)(14)(15). Results might have been influenced by the used method to calculate the red marrow dose, the radionuclide used, or patient-specific factors.…”

mentioning

confidence: 88%

“…In several studies, methods are defined to estimate the red marrow dose based on blood activity data or planar scintigrams (5)(6)(7)(8). Previous studies on the relationship between radiation dose estimates and myelotoxicity were variable (7,(9)(10)(11)(12)(13)(14)(15).…”

mentioning

confidence: 99%

See 3 more Smart Citations

Dosimetric Analysis of ¹⁷⁷Lu-cG250 Radioimmunotherapy in Renal Cell Carcinoma Patients: Correlation with Myelotoxicity and Pretherapeutic Absorbed Dose Predictions Based on ¹¹¹In-cG250 Imaging

Stillebroer¹,

Zegers²,

Boerman³

et al. 2011

J Nucl Med

View full text Add to dashboard Cite

This study aimed to estimate the radiation absorbed doses to normal tissues and tumor lesions during radioimmunotherapy with 177 Lu-cG250. Serial planar scintigrams after injection of 111 In-cG250 or 177 Lu-cG250 in patients with metastasized renal cell carcinoma were analyzed quantitatively. The estimated radiation doses were correlated with observed hematologic toxicity. In addition, the accuracy of the predicted therapeutic absorbed doses, based on diagnostic 111 In-cG250 data, were determined. Methods: Twenty patients received a diagnostic tracer activity of 111 In-cG250 (185 MBq), followed by radioimmunotherapy with 177 Lu-cG250. The administered activity of 177 Lu-cG250 was escalated by entering 3 patients at each activity level starting at 1,110 MBq/m 2 , with increments of 370 MBq/m 2 . After each diagnostic and therapeutic administration, whole-body scintigraphic images and pharmacokinetic data were acquired. Hematologic toxicity was graded using the Common Toxicity Criteria, version 3.0. Diagnostic 111 In-cG250 data were used to simulate 177 Lu and 90 Y data by correcting for the difference in physical decay. Absorbed doses were calculated for the whole body, red marrow, organs, and tumor metastases for the therapeutic 177 Lu-cG250, simulated 177 Lu-cG250, and simulated 90 Y-cG250 data. Results: Observed hematologic toxicity, especially platelet toxicity, correlated significantly with the administered activity (r 5 0.85), whole-body absorbed dose (r 5 0.65), and red marrow dose (r 5 0.62 and 0.75). An inverse relationship between the mass and absorbed dose of the tumor lesions was observed. Calculated mean absorbed doses were similar for the simulated and measured 177 Lu-cG250 data. Absorbed doses (whole body and red marrow) based on the simulated 177 Lu-cG250 data correlated with the observed platelet toxicity (r 5 0.65 and 0.82). The tumor-to-red marrow dose ratio was higher for radioimmunotherapy with 177 Lu-cG250 than for radioimmunotherapy with 90 Y-cG250, indicating that 177 Lu has a wider therapeutic window for radioimmunotherapy with cG250 than 90 Y. Conclusion: In patients with metastasized renal cell carcinoma, hematologic toxicity after treatment with 177 Lu-cG250 can be predicted on the basis of administered activity and whole-body and red marrow-absorbed dose. Diagnostic 111 In-cG250 data can be used to accurately predict absorbed doses and myelotoxicity of radioimmunotherapy with 177 Lu-cG250. These estimations indicate that in these patients, higher radiation doses can be guided to the tumors with 177 LucG250 than with 90 Y-cG250.

show abstract

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 88%

mentioning

confidence: 99%

See 2 more Smart Citations

Dosimetric Analysis of ¹⁷⁷Lu-cG250 Radioimmunotherapy in Renal Cell Carcinoma Patients: Correlation with Myelotoxicity and Pretherapeutic Absorbed Dose Predictions Based on ¹¹¹In-cG250 Imaging

Stillebroer¹,

Zegers²,

Boerman³

et al. 2011

J Nucl Med

View full text Add to dashboard Cite

show abstract

“…However, the extensive dosimetry and biodistribution data obtained during the analysis of Lym-1-based RIT were extremely valuable in the advancement of the field of RIT in NHL. 10,13 For instance, it was shown that the kinetics of indium-labeled antibody were similar and could predict the yttrium-labeled antibody distribution, which supported the clinical development of 90 Y-ibritumomab-tiuxetan (Zevalin). 14 Furthermore, theoretical and practical considerations for fractionated RIT were addressed in these very important studies at the University of California in Davis.…”

Section: Selection Of Targets For Rit Historical Developmentmentioning

confidence: 99%

Radioimmunotherapy for Non-Hodgkin Lymphoma : Historical Perspective and Current Status

Emmanouilides

2007

J Clin Exp Hematopathol

View full text Add to dashboard Cite

90 Y-ibritumomab tiuxetan utilizes a monoclonal anti-CD20 antibody to deliver b-emitting yttium-90 to the malignant B-cells. Clinical trials have demonstrated its efficacy, which is largely independent of the intrinsic activity of the anti-CD20 antibody. A similar anti-CD20 radiotherapeutic compound, 131 I-tositumomab, was subsequently approved in the USA. The advantages of increased efficacy compared to the naked antibody are gained at the expense of myelotoxicity which is dose limiting but reversible. Studies exploring expanded applications of radioimmunotherapy have been recently completed or are under way. It is hoped that RIT will be an ideal agent for consolidation after chemotherapy for both indolent and aggressive non-Hodgkin lymphoma as well as a useful addition to preparatory high dose regimens prior to transplant. RIT has been shown to be an effective and clinically relevant complementary therapeutic approach for patients with lymphoma. 〔J Clin Exp Hematopathol 47(2) : 43-60, 2007〕

show abstract

Choosing an optimal radioimmunotherapy dose for clinical response

DeNardo¹,

Williams²,

Leigh³

et al. 2002

Cancer

Self Cite

View full text Add to dashboard Cite

Clinical trials have documented the single-agent efficacy of radioimmunotherapy (RIT) in lymphoma, and several combination therapy studies are now in progress.RIT agents are currently becoming generally available for clinical use in lymphoma therapy. Solid tumors, which are notoriously less responsive to any single agent, have demonstrated clinically useful responses, albeit temporary, and multimodality studies have been instituted. However, a sincere debate continues regarding the basic parameters to be used to define appropriate therapeutic dosing when using

show abstract

Imaging for improved prediction of myelotoxicity after radioimmunotherapy

Cited by 26 publications

References 12 publications

Dosimetric Analysis of ¹⁷⁷Lu-cG250 Radioimmunotherapy in Renal Cell Carcinoma Patients: Correlation with Myelotoxicity and Pretherapeutic Absorbed Dose Predictions Based on ¹¹¹In-cG250 Imaging

Dosimetric Analysis of ¹⁷⁷Lu-cG250 Radioimmunotherapy in Renal Cell Carcinoma Patients: Correlation with Myelotoxicity and Pretherapeutic Absorbed Dose Predictions Based on ¹¹¹In-cG250 Imaging

Radioimmunotherapy for Non-Hodgkin Lymphoma : Historical Perspective and Current Status

Choosing an optimal radioimmunotherapy dose for clinical response

Contact Info

Product

Resources

About

Imaging for improved prediction of myelotoxicity after radioimmunotherapy

Cited by 26 publications

References 12 publications

Dosimetric Analysis of 177Lu-cG250 Radioimmunotherapy in Renal Cell Carcinoma Patients: Correlation with Myelotoxicity and Pretherapeutic Absorbed Dose Predictions Based on 111In-cG250 Imaging

Dosimetric Analysis of 177Lu-cG250 Radioimmunotherapy in Renal Cell Carcinoma Patients: Correlation with Myelotoxicity and Pretherapeutic Absorbed Dose Predictions Based on 111In-cG250 Imaging

Radioimmunotherapy for Non-Hodgkin Lymphoma : Historical Perspective and Current Status

Choosing an optimal radioimmunotherapy dose for clinical response

Contact Info

Product

Resources

About

Dosimetric Analysis of ¹⁷⁷Lu-cG250 Radioimmunotherapy in Renal Cell Carcinoma Patients: Correlation with Myelotoxicity and Pretherapeutic Absorbed Dose Predictions Based on ¹¹¹In-cG250 Imaging

Dosimetric Analysis of ¹⁷⁷Lu-cG250 Radioimmunotherapy in Renal Cell Carcinoma Patients: Correlation with Myelotoxicity and Pretherapeutic Absorbed Dose Predictions Based on ¹¹¹In-cG250 Imaging